Professor Yang rushed over from home, and Mr. Chen had already asked about the medical history. The patient indeed bought Ascaris egg capsules half a year ago and took them orally for weight loss.
It is said that the effect is quite good, and the patient has lost significant weight in the past six months.
But 12 days ago, she started to have upper abdominal pain. Because she was in her menstrual period, the patient thought it was radiating pain and didn't pay much attention at the time. But after her menstrual period, she still had a dull pain in her upper abdomen, and she still did not come to the hospital for treatment.
Because she had nausea and retching, she always thought it was a gastrointestinal flu, so she took corresponding medicine and prepared her resume to find a job.
Unexpectedly, my condition suddenly worsened today, to the point where I was vomiting worms.
When this happened, Professor Yang watched the film. According to the medical history, there should be roundworm obstruction in the biliary tract. The roundworms burrow into the biliary tract from the greater part of the duodenum, causing biliary obstruction.
Different from other parasites, roundworms are longer and thinner, and the location of the borehole is also deeper.
This surgery... is troublesome. Professor Yang has a black line on his forehead.
Nowadays, biliary roundworms are not very common. After all, there are so many anthelmintic drugs. If you feel something is wrong, just take anthelmintic drugs.
And the symptom most likely to be induced by roundworms is intestinal obstruction, not biliary obstruction.
Cut? The location is very deep, cutting the liver to remove the roundworms... To be honest, Professor Yang really doesn't dare to do this surgery.
If it were cut open, it would be difficult to find the exact location of the roundworm, but this was not a problem for the professor who led the 912 team. Any professor in the Department of Hepatobiliary Surgery can find a position.
But the difficulty lies in the next step, how to take out the bugs intact and intact.
And... there are roundworms in the gastrointestinal tract, and they can come out of the mouth, but there may not be many worms there.
Professor Yang glanced at the time, it was one thirty-five in the morning.
No matter what, let’s seek consultation from the whole hospital!
immediately!
immediately!
In his opinion, ERCP and retrograde stone removal can also be considered to remove the roundworms, and the damage is small and it is a minimally invasive surgery.
I just don’t know if the people in the endoscopic laboratory dare to do it or not.
Whether you dare or not, worms in the bile duct are one thing, but worms in the gastrointestinal tract also need to be removed. You can't cut open the entire gastrointestinal tract and reach in to pick out the worms. It’s hard to tell whether it can be removed cleanly, and the patient will suffer severe trauma.
Call for emergency consultation.
Although it was quite annoying to ask for consultation from the whole hospital at this point, the patient was rolling on the flat car in pain, but there was no delay.
There is no staff on duty at night for gastrointestinal endoscopy, and this kind of emergency may not happen once a year or two. If there is related surgery, you still have to call and come from home.
35 minutes later, the second-line professor in the endoscopy room rushed over. He looked at the video data as if he were seeing each other, without saying a word.
After watching it for 10 minutes, he sighed, discussed it with Professor Yang, and called Director Luo from home.
After taking the stage, he talked and laughed and said that he was not afraid. The doctor said nonchalantly that it was fine. Under normal circumstances, it was fine, and it was not that he didn't take it seriously.
What I was most afraid of was that doctors were called from home one after another at such a late night. They were getting higher and higher in rank, older and older, and their expressions were getting more and more serious. Everyone knew what this meant.
But the last ones to receive the call were Zheng Ren and Su Yun. It is quite rare to suddenly become younger.
"Who's calling you in the middle of the night? If there's an emergency, just go there. What did you ask me to do?" Su Yun was full of anger after being woken up.
"It is said that there is a patient with biliary ascariasis, and the location is relatively deep." Zheng Ren was already preparing to set off and urged: "Hurry up."
"Isn't it enough for you alone? Are you ready for ERCP? Let me sleep a little longer." Su Yun said no, but his body was very honest.
He was nagging unhappily while getting dressed.
"I'm considering using a balloon on one side and a catching forceps on the other. It requires two operators, and it can't be done by one person." Zheng Ren said seriously: "Hurry up."
"Brother, biliary roundworms are not fatal!" Su Yun was really angry when he got up, and he didn't even ask the boss to start calling him brother.
But having said that, Su Yun quickly put on his clothes, and the two of them tiptoed downstairs.
Kuroko squatted at the stairs and looked at the two of them with wide eyes. In the dark night, Heizi's eyes glowed green, a little fierce.
"Shh." Zheng Ren went downstairs and stroked the dog's head. "Let's go to work. You have a good sleep."
"Hurry up, do emergency rescue, and pet the dog?" Su Yun said directly.
"Keep your voice down, they are both sleeping." Zheng Ren put on his shoes and opened the door.
"How long has it been since you were woken up in the middle of the night?" Su Yun asked, sighing.
"It's been two months," Zheng Ren said. "It's so comfortable to have no emergency room."
"It's been many years since I've seen a patient with biliary roundworms. For this disease, people usually take anti-parasitic medicine to kill them first. In the future, take them if you can. If you can't, wait for calcified stones. What's going on today?" Su Yun reviewed his condition from the beginning, and he could complain about many doubtful points.
"Maybe the patient's condition is special? Director Luo tried it, but the roundworm was pulled out, and half of it was left in the bile duct." Zheng Ren guessed casually.
Taking the elevator downstairs, the two of them ran through the night of the imperial capital.
Zheng Ren still hasn't bought an electric car. Although the security is much better now, he doesn't use it often. Just charging it is troublesome. It would be more convenient to run, or so he thought.
Simplicity and directness are Zheng Ren’s aesthetics.
Quickly arriving at the endoscopy room, Zheng Ren changed his clothes and walked in. He saw a figure flashing at the door of the ERCP room. Just as I guessed, I am planning to use ERCP to solve the problem.
Zheng Ren strode over, but did not see the ERCP operation. Director Luo is operating the gastroscope, taking things bit by bit.
Glancing at the screen, Zheng Ren was stunned.
What the hell is this! Zheng Ren cursed in his heart.
Under a gastroscopy, you can see looming white things in the stomach. Why is it in the stomach? ! Zheng Ren was also a little puzzled.
Generally speaking, although roundworms are not afraid of them, they will not survive in stomach acid. Too acidic and not a "livable" environment for them.
But in an instant Zheng Ren thought of several possibilities, such as severe vomiting, reduced gastric acidity and reflux of contents in the jejunum, passing through the pylorus and entering the stomach, which could lead to the situation like this.
But in any case, so many roundworms are rare, very rare, Zheng Ren made a prediction in his mind.
"Boss Zheng, you are here." Professor Yang greeted.
"Well, take out the stomach first?" Zheng Ren nodded, "Director Luo, what about the preparations for the bile duct later?"
"First remove the worms from the stomach and colon. If there is a problem with the ERCP, we will discuss it later." Director Luo concentrated on the operation and briefly shared his thoughts with Zheng Ren.
Zheng Ren walked in and was shocked to see a red trash can next to Director Luo, with more than a dozen yellow and white roundworms squirming inside.