"The patient now has melena, and the report came out, and the fecal occult blood was positive." Zhu Liangchen added after "reporting" the medical history.
This is the result just reported by his deputy director. There is nothing to hesitate about. The diagnosis is very clear. The patient has lower gastrointestinal bleeding.
There are countless considerations for positive fecal occult blood after surgery. However, after interventional surgery, it is not a liver interventional surgery. The patient has splenomegaly, liver cirrhosis, and gastric varices, and it is very rare to have positive fecal occult blood.
If he couldn't find the problem, Zhu Liangchen felt like he couldn't sleep.
Zheng Ren was not as polite as when he entered the room. He listened to Zhu Liangchen talk about the treatment process and stared at the film.
Out of habit, Zheng Ren held his chin with his right hand, placed his left hand under his right armpit, and narrowed his eyes.
After Zhu Liangchen reported the medical history, he also looked at the film.
This is not the latest film. Could it be that Boss Zheng just said no and wanted to make another film later? But what tests are needed to find out? Gastroenteroscopy
Zhu Liangchen thought about countless possibilities, but fortunately he reported to him at home that the patient's condition was stable and the blood in the stool had not worsened, so he felt relieved.
After a full ten minutes, Zheng Rencai said: "The CT scan is not very clear."
Zhu Liangchen felt a chill in his heart. This was Tai Chi Kung Fu, a word that even experienced doctors could master.
Boss Zheng doesn't know either, or is he just perfunctory
But as soon as the thought came to his mind, Zheng Ren continued.
"But the ulcer at the pylorus has already shown up."
"..." Zhu Liangchen and Director Kong both frowned.
CT cannot see hollow organs, such as the gastrointestinal tract. If there is a huge solid tumor, CT can still see it, but the patient is not a tumor.
"Director Zhu, I don't know if you noticed or not, but the patient's stomach wall is dilated." Zheng Ren continued.
"I noticed it. I think it was caused by embolization of some arteries, insufficient blood supply, and slowed gastric emptying." Zhu Liangchen said immediately.
Zheng Ren shook his head and said: "The problem is indeed slowed gastric emptying. Please give me the doctor's instructions for post-operative medication."
He said something here and there, but Zhu Liangchen did not argue. Instead, he took out his mobile phone and called up the doctor's instructions for taking pictures.
You must have a begging attitude when asking for help. Moreover, Dr. Mehar just came to watch the movie. The scene of a row of foreign experts standing against the wall completely shocked Zhu Liangchen.
He had no other ideas and knelt down very thoroughly.
After Zheng Ren read it, he had a comprehensive treatment plan in mind. He paused and said, "Director Zhu, go back for a gastroscopy and remember to take a biopsy."
"Biopsy?" Zhu Liangchen was stunned. Did he encounter a rare malignant tumor? I can't. I've watched the movie so many times, but I can't figure it out.
Zheng Ren just talked to himself, with a slightly slower pace. He didn't expect Zhu Liangchen to think of so many things at this moment.
"Biopsy tissue and do bacterial culture." Zheng Ren said.
"Bacterial culture? What do you suspect?" Zhu Liangchen wanted to ask, Helicobacter pylori? Isn’t that nonsense
"Are you familiar with the laboratory department?" Zheng Ren suddenly asked.
Even Su Yun felt that his boss was so mysterious. Did he expand into outer space after communicating with Dr. Mehar
"good."
"When you send the specimen, Director Zhu, please personally greet your acquaintances in the laboratory department. It is not an ordinary bacterial culture. It depends on whether there is Sarcina gastroenteritis." Zheng Ren said.
"..." Zhu Liangchen was speechless.
"..." Director Kong was speechless.
Only Su Yun raised his eyebrows slightly, as if he thought of something.
"Boss Zheng, what is that?" Zhu Liangchen really didn't know if Boss Zheng was making things difficult for him or if it was really something. He came here today to ask for forgiveness, and Boss Zheng greeted him with a smile, which was considered a special honor. So he could only ask in a low voice and didn't dare to say anything else.
"Gastrosarcina is often composed of eight cells regularly stacked together in a cube shape. It is a microaerobic bacterium that is easily isolated from the soil. It can also be found in the stomach contents of patients with gastric diseases. "
Zheng Ren pointed to a section of uneven density on the film and said, "Here, I think it is a pyloric ulcer. The area of the ulcer is not too small."
"The growth of gastric Sarcina in the human stomach causes certain pathological changes, such as pyloric ulcers and pyloric stenosis, etc., resulting in slow flow of food into the intestines. In this abnormal situation, the stomach is in acidic conditions, and food in the The carbohydrates and other nutrients contained for growth promote the rapid proliferation of gastric Sarcina."
Zhu Liangchen was confused and asked in a daze: "What next?"
Zheng Ren was also a little surprised and looked sideways at Zhu Liangchen, as if he had seen something incomprehensible.
"Boss, the doctors who intervened are all videographers." Su Yun reminded in a low voice from the side.
"Oh." Zheng Ren suddenly realized.
Director Kong and Zhu Liangchen's faces felt like they had been slapped several times. They really wanted to push Su Yun to the ground and beat them up.
Isn’t it a doctor who comes from a background in imaging
"Professor Goodsir first discovered gastric Sarcina in a patient's stomach in 1842. Professor Ferrier also discovered its presence in the patient's blood in 1872 and believed that its presence in the blood was related to the delay in gastric emptying." Zheng Ren then explained.
"It's normal that Director Zhu doesn't know. Clinically, the department where Sarcina is most common is general surgery, and even gastroenterology is not very common."
"General surgery? Why?" Director Kong asked.
"Because of the previous gastric band surgery, the possibility of gastric Sarcina appearing after surgery is quite high." Zheng Ren smiled, "So I mentioned the paper from Johns Hopkins Hospital. It’s debatable, and here’s why.”
"That paper did not mention how to prevent and treat gastric Sarcina after surgery, nor did it mention any complications. It just said that the long-term efficacy is better."
"I wanted to wait and think about it after Dr. Mehar left, but Director Zhu took action first." Zheng Ren said very seriously, but there was no mockery in his tone, and Zhu Liangchen felt upset.
Even if I really want to have an attack, I feel depressed even if I don't have an attack. Especially when he saw Zheng Ren's honest and honest face, he felt even more helpless. Zheng Ren was not deliberately mocking himself, Zhu Liangchen knew this.
But the more this happens, the more it seems that what he did before is extremely stupid.
Director Kong smiled bitterly. It turned out to be a complication commonly seen after general gastric banding surgery. No wonder Su Yun reminded Boss Zheng that those involved in the intervention were all from imaging backgrounds.
I have never had gastric band surgery, so who knows what the hell about gastric sarcina.
Thinking about it, Director Kong couldn't help but want to curse.
This is simply an insult to interventional doctors, but... I'm right, what can I do
Director Kong sighed.