"Since Director Tang has said so, then I have nothing to worry about."

Zhou Can sat down with peace of mind.

Male and female colleagues spend time alone in order to communicate with each other, which is almost common in large engineering divisions. For example, a subordinate reports to his boss, or comes to consult like Zhou Can at this moment.

"Hehe, let's not be afraid of shadows! Let's get down to business, this is the patient's medical records, and the tests that should be done have basically been checked. He has been treated in other hospitals for a long time, but the effect is not satisfactory. I organized relevant experts in the department, and even invited experts from the Department of Gastroenterology to consult, but the real cause was still not found. ”

Director Tang Fei showed the child's information to Zhou Can for review.

In medicine, it is customary to refer to patients under the age of 14 as children. The child is a male and has turned 14 years old this year. The first presenting symptoms are edema of the lower limbs for more than half a year and abdominal distention.

Symptoms such as nausea and vomiting were also mentioned upon admission to the hospital.

"The parents of this child are really big-hearted, and they have had edema of their lower limbs for more than half a year, and they have not taken their children to the hospital for examination."

After reading the medical history, Zhou Can shook his head and sighed.

Many intractable diseases are dragged out little by little. It's really like raising a tiger.

"You can't blame the parents of the children. The child's father is an official, and his mother is the female president of a large company, and the family is rich and powerful. is such a child, naturally looking like a baby. I heard that there are several tutors for children alone, and there are also special nannies. The only disadvantage is that the child's parents are very busy and have little time to spend with the child. ”

No wonder Director Tang Fei is so concerned.

Every country in the world is a humane society, even since ancient times. Whether it is a previous feudal dynasty or a modern society ruled by law, human relations are always the unspoken rules of social rules.

The noble sons of feudal society, the children and relatives of officials have caused trouble and done illegal and criminal things, do the county commanders dare to arrest people?

Even if they really get in the way of public anger and arrest people, it will be difficult to resist the pressure from all sides, and finally secretly let them go.

The county magistrate and the noble son who committed the crime may not know each other at all, nor do they know his family. Then why do you want to let people go at the risk of violating the royal law?

The uncle of the noble son of the family is the prefect, and the official position is much larger than the county order.

This alone is enough for the county to release the people.

The uncle of the noble son is also an understanding person, and secretly sent a sum of silver to the county order, not to mention, but also told him that if there is anything in the future, he will take care of one or two. As long as the county order is not stupid, most of them will 'gladly' accept it.

Inflammation is an instinct of human beings to survive in society after thousands of years of evolution.

It's a bit similar to avoiding evil, but it's a little more complex and advanced.

The parents of this child may have already been in contact with Director Tang Fei, and even greeted the dean or hospital leaders. In this case, Director Tang Fei needs to actively treat this child.

It's cured, and it's a great achievement.

Even if you can't be cured, you have to behave positively.

Zhou Can nodded and continued to review the patient's medical records and medical history.

After the child's nausea and vomiting symptoms appeared, the nanny was worried that the child had something wrong and quickly informed the child's parents. Then I hurriedly took the child to the hospital for treatment.

The first hospital is the Provincial Children's Hospital, and it is a specialist.

Look at the children of rich families, this treatment is almost no different from the sons of powerful people in ancient times.

In ancient times, when princes and princes were sick, they would directly ask the imperial doctor to go for treatment. Use the best Lang Zhong and take the best medicine.

The children of modern magnates go to the top hospitals in the province to find specialists.

The specialist gave the child three routine examinations, namely blood routine, urine and stool routine, and then did an abdominal ultrasound.

Routine blood showed a WBC result of 3.3 x 10 to the power of 9 per liter.

PLT189*10 to the 9th power per liter, it is routinely normal.

Ultrasound of the abdomen shows an enlarged spleen.

The child presents with fatigue, a flat abdomen, no tenderness and rebound tenderness, and no palpation of the liver under the costals. The spleen is about 3 cm below the costal surface and the texture is soft, and a moving dullness is heard.

The child was then found to have mild edema in both lower limbs, which was not serious.

When the expert examined the child, the subcostal liver was not palpated, and I don't know if it was because he was worried about causing the child to be disgusted and resistant, so he didn't dare to check it or what was going on.

Anyway, it can be seen from the inspection that it is very regular.

Quite conservative.

It can also be inferred from this that the specialists of the provincial children's hospital were under a certain amount of pressure when they received the child.

Is it because the parents of the child are not talkative?

Because the child's father is an official, and his mother is the president of a large company, she is rich and powerful, and she only has such a son. Now that I find out that my son is sick, I am inevitably anxious.

It is also possible to put some pressure on the attending doctor in terms of words and attitudes.

In short, the experts who received the examination only did a few basic examinations, and they did not dare to open more than one examination.

The treatment is even more interesting, with the child fasting for two days.

I didn't prescribe any targeted treatment drugs, but I fasted the child for two days, and then something miraculous happened, and the child's condition improved significantly.

An expert is an expert, and the level is really high.

There was no medicine, just let the child fast for two days, and the child's illness was cured.

Unfortunately, the good times did not last long, and less than two weeks later, the child became ill again. The specialist was found again, and this time the diagnosis was given as a preliminary suspicion of duodenal ulcer. The specialist fasted the child for two more days.

This expert is truly a god-like expert.

After two days of fasting, the child's condition improved again.

When Zhou Can saw this, his head suddenly became a little big. It's been a long time since I've encountered such a bizarre and difficult case. He intuitively felt that this case was definitely a rare disease of hellish difficulty.

No wonder Director Tang Fei found so many experts for consultation, but there was no result.

The specialist at the Provincial Children's Hospital tried fasting therapy twice but failed to cure the child. After each fasting, the child's condition may improve significantly, and then repeat.

Zhou Can was secretly thinking, could it be that there was a problem with the child's diet?

Some rich and noble families are very willing to spend money on food, all kinds of delicacies from the mountains and seas, big fish and meat, and supplements until they get tired of eating.

Could this child's illness be a food accumulation disease?

Looking down, when the child's condition recurs for the fourth time, the family may feel that the expert is unreliable and change the doctor. However, he is still being treated at the Provincial Children's Hospital. The new specialist couldn't resist the pressure and began to treat the child with medication.

The drugs and methods of treatment are all in accordance with the standard treatment plan for duodenal ulcer.

However, after treatment, the child's condition did not improve significantly.

That's a lot of fun.

Without taking medicine and fasting for two days, the condition can improve. Now the medication is being used, but it has no effect.

It is estimated that the newly replaced expert is scolding the sky in his heart, it is really evil.

The previous specialist did not use drugs, and fasting alone could make a significant improvement. Why did I start by myself and carefully prescribe medicine for symptomatic treatment, but it had no effect?

The specialist scolded himself for being unlucky and prescribed a new examination for the child.

That's all there is to it.

The blood routine showed that the WBC rose to 5.62*10 to the 9th power per liter. LY, approximately 51%, the state of HB approximately 104g/L.

Considering that the child has been experiencing edema in the lower limbs, it is not serious.

In addition, after treatment, the condition did not improve, and I began to wonder if there was a problem with the kidneys.

Under normal circumstances, the kidneys of a 14-year-old boy are at the best stage of life. At this time, boys generally have no sexual life, and even the first sperm loss may not have appeared.

The kidneys are as clean and intact as a piece of jade.

After the urine test, the 24-hour urine protein measurement was normal. Note that the 24-hour urine protein quantification was checked.

This indicates that the child's kidney function is normal.

Considering that the child had symptoms such as nausea and vomiting, the stool routine was checked again.

This time, there was a new discovery, and the stool OB was intermittently positive.

What does that mean?

Fecal OB means occult blood in the stool. Intermittent positive indicates that the child sometimes has blood in the stool.

There are many causes of blood in the stool, the main one being gastrointestinal bleeding.

And it's likely to be intermittent bleeding.

The second expert was thrilled with his discovery. Finally, there is a little new progress.

Based on this clue, another stool Sudan stain was checked, and the result was negative this time.

Seeing that the result was negative, the expert was probably also relieved.

Because if the stool stain is positive, it is likely to be a malignant disease.

Normal people have negative Sudan staining results.

When too much neutral fat is excreted, the Sudan stain result will be positive. This predicts conditions such as hepatic compensatory dysfunction, pancreatic lesions, acute diarrhea, and steatorrhoea.

It is common in acute and chronic pancreatitis, pancreatic head cancer, malabsorption syndrome, small intestine absorption dysfunction, and pediatric diarrhea.

The second expert began to focus on the digestive tract based on the clues of intermittent positive fecal occult blood.

First, the child was given a whole gastrointestinal imaging.

Zhou Can can deduce that the expert at this time must be full of confidence, and he is holding back a lot of strength in his heart, Lao Tzu will definitely be able to find the cause of this child. And it's going to be found right away, and it's a great achievement.

The whole GI angiography was not done in vain, and the duodenal mucosa of the child was significantly thickened.

At such a young age, the duodenal mucosa is thickened, which means that the disease has been occurring for a long time.

It's like the palms of our hands, if we only do heavy physical work for a day or two, it is impossible to grind out calluses.

Only by doing some hard work for a long time can it be possible to grind out the cocoon.

The more cocoons and thicker they are, the longer the hard work will be.

Rough duodenal mucosa often means that the patient has long-term chronic inflammatory manifestations, which is related to factors such as long-term irregular diet and lack of exercise.

It's not a big deal, at least in Zhou Can's opinion, it's not a big deal.

If it is just a rough duodenal mucosa and there are no other symptoms, there is no need to treat it at all. Just pay attention and review it regularly.

If you are organized, you can stick to soothing and gentle exercises, and eat a light and digestible diet.

For example, eating gruel, noodles, lotus root flour, milk, soy milk, oranges, etc., as long as you eat on time, there is generally nothing to do with a regular life.

The situation can also be changed very quickly.

The second expert took great pains to check the whole gastrointestinal imaging of the child, and finally only found such a little, as you can imagine, he must have been extremely unwilling and very disappointed.

It's like when we see a fish pond, the water is very deep and the area is so large that we can even see fish jumping out of the water from time to time.

I thought to myself, there must be a lot of fish in this fish pond, not to mention catching 10,000 catties, at least a few thousand catties is no problem.

Then the water was drained, and it took a lot of effort to catch a few buckets of small fish and shrimp.

The expert from the Provincial Children's Hospital originally wanted to catch a 'big fish', but he only caught a 'small fish', so it is no wonder that he was not disappointed.

Sometimes this is how the doctor checks the disease, locks on the target with confidence, and then painstakingly checks a blank.

If this expert didn't find out the problem, he must be unwilling, and he can't explain it to his family.

So the next check began.

What to look for?

Gastroscope.

Intermittent occult blood in the stool indicates that there must be bleeding spots.

Zhou Can once cracked such a similar case, the patient also had gastrointestinal bleeding, but the cause could not be found. Later, after Zhou Can's unremitting efforts, it was finally discovered that the patient was infected with a rare parasite.

Because of this case, he also wrote a paper with Dr. Shi in the Department of Intensive Care Medicine, which was first published in a core medical journal in China.

Later, it was also included in the SCI medical journal.

Dr. Shi also successfully won the deputy senior professional title.

The benefits obtained by Zhou Can are also not small. With his conditions and knowledge, he could reach such a high height for the first time writing a thesis, which was something he never dared to imagine. It also greatly increased his potential points.

Later, when he went to Xinxiang Women's and Children's Hospital for consultation, he was selected by the hospital to be selected into the reserve talent sequence of the famous medical hall, and the SCI paper has a certain credit.

Since the invention of gastroscopy, it can help doctors accurately detect many diseases of the upper gastrointestinal tract.

Lesions that are difficult to detect including CT, ultrasound, and even MRI can be detected by gastroscopy.

After the expert examined the gastroscopy of the child, he really made a new major discovery.

The child has atrophic gastritis and duodenal mucosal edema.

Somewhat similar to gyrus edema.

When doing gastroscopy, a duodenal sample was taken casually for pathology.

To be honest, after checking this step, I have already begun to wonder if it is cancer.

It is very necessary to do a pathology.

Because it has been treated according to duodenal ulcer in the early stage, it has no effect at all.

Based on clinical experience, the presence of such lesions is clearly found, but the treatment of the disease is ineffective, which often indicates that the results may be terrible.

After pathological examination, it was determined that the child had severe acute and chronic inflammation and villous atrophy.

At this time, a disease name popped up in Zhou Can's mind, external celiac disease.

Celiac disease, also known as gluten gum enteropathy and non-tropical steatorrhea, has a relatively high incidence in developed countries, but it is rare in China.

What Zhou Can could think of at this time was that rich and noble families have the suffering of rich and noble families, such as 'rich and noble disease'.

(End of chapter)