Five Hundred and Forty-Three Trust

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"The patient, female, 22 years old, with a clear mind...has dysplasia and poor nutrition. On February 14, she went to the obstetrics and gynecology department of our hospital with nausea, vomiting, abdominal pain, and abdominal distension. The obstetrics and gynecology department completed relevant examinations and various physical examinations. After no obvious abnormality was found, the Department of Gastroenterology of our hospital was invited for consultation.

After consultation with the Chief Physician of the Gastroenterology Department of our hospital, the patient’s symptoms improved after giving the patient antispasmodic drugs to promote gastrointestinal motility, but on February 16, the above symptoms aggravated. No obvious improvement was seen.

Therefore, after the patient was transferred to the Department of Gastroenterology, colonoscopy and gastroscopy were performed. The colonoscopy showed obvious purulent mucus in the patient's intestines, and intestinal infection was considered. After giving anti-infective drugs on the same day, the patient did not see any obvious improvement.

Therefore, after tertiary diagnosis and treatment, the Department of Gastroenterology decided to apply for hospital-wide consultation. After reporting to the dean, the dean agreed, and the approver was Dean Zhang Fan! "

After Lao Chen picked up the microphone, he began to talk about the patient's chief complaint and the diagnosis and treatment process, and the experts present already had a copy of the medical records and examinations.

But everyone is holding the examination and medical records in their hands, and each expert has already started to think about the diagnosis in his own mind according to his own discipline.

Ouyang looked at the report in his hand and put it down. Over the past few years, the old lady has either been thinking about the personnel structure of the hospital, or fighting wits with the contractors on the construction site. The professional, especially interdisciplinary cases have been unable to keep up.

"Have you ever seen such a case? Have you communicated with everyone before the meeting?"

"No!" Zhang Fan looked at the case and said softly.

Ouyang took a breath of cold air, and his teeth creaked. "You are too careless. If you don't step down today, you will probably be ashamed and thrown to the capital!"

Ouyang is worried. After reading the medical case, Zhang Fan smiled at Ouyang, "It's all right!"

Then, after looking at the experts in the venue, they had already put down the case in hand. "Everyone has read the case, okay, let's talk about it now. Since it was first received from the obstetrics and gynecology department, the obstetrics and gynecology department will talk about it first."

Zhang Fan nodded to several experts in obstetrics and gynecology.

The director of obstetrics and gynecology said a word to Lu Shuyan softly, and Lu Shuyan stood up.

"After the patient was admitted to the hospital, our department first confirmed that the patient was not pregnant." Many people were very curious during the hospital examination. Girls entered the hospital when they were of childbearing age, whether it was a greasy general surgeon or a thick orthopedic doctor. , Anyway, after asking what you feel uncomfortable, you will ask if you are married, whether your menstruation is normal or not.

It seems like a parent urging marriage during the Chinese New Year, but in fact it is a medical regulation. Women of the right age must ask if they are pregnant, because many tests and medicines must not be used during pregnancy.

"Although the patient's menstruation is intermittent at present, according to various data, the patient's irregular menstruation is not the direct cause of abdominal pain, abdominal distension and nausea, but the patient's abdominal pain and abdominal distension have actually affected the patient's gynecological system..."

Lu Shuyan was able to practice, and explained the signs of each patient in great detail. The head of the gynecology department nodded in satisfaction.

If Zhang Fan is Ouyang's darling, then now Lu Shuyan is the prince of gynecology. At present, Lu Shuyan is the assistant to the director. Although she does not have the title of deputy director, she is responsible for the department's current schedule, business study, and emergency surgery.

"This senior sister is so handsome and cold!" Among the interns, a few single dogs secretly thought in their hearts.

After the introduction of gynecology, the introduction of gastroenterology.

...

After the speeches of each department were finished, the experts began: "Although I didn't see the patient, I think we can continue to observe. The rounds three times a day can be divided into rounds every two hours. There will always be rounds with her before she gets sick. After the onset of illness, clues were found."

Experts from Maruko Country expressed their opinions. In the meatball country, the number of doctors managing beds is small. Therefore, they put more emphasis on clinical observation.

"Infectious white pus was found in the bowel,

Although the specific cause of infection cannot be determined at present, we can confirm the diagnosis by exploratory laparotomy. "

Zhao Jingjin zoomed in on his moves.

"No, the patient's current nutritional status obviously does not support surgery. Moreover, at present, the patient's focus is not on the small amount of infected fluid secreted by the intestines, but on what caused her obvious nausea and vomiting."

Yan Xiaoyu opposed the laparotomy.

This is the biggest difference between internal medicine and surgery. Surgery is simple and crude. Internal medicine focuses on mechanisms and principles.

Internal medicine cannot convince surgery, and surgery cannot convince internal medicine.

"Well, based on everyone's current suggestions, my opinion is that we should conduct another systematic physical examination."

"Okay, I agree!"

"I agree!"

...

"Hey, there is still no master who can make the final decision. If this disease is in our affiliated hospital, the boss of the gastroenterology department may be able to spot it at a glance."

"I don't think so. I read the patient's account yesterday, and I didn't have a clue. It was nausea and vomiting that happened occasionally and irregularly. My first reaction was that she was pregnant. After ruling out pregnancy, I couldn't think of any other diseases she had. All checks are normal!"

Several students got together and discussed.

Comprehensive line of treatment, and now more and more popular in the world. However, the cost is too high. Some hospitals in Huaguo have set up outpatient clinics and wards with comprehensive departments, but the effect is really nonsense.

If comprehensive diagnosis and treatment are combined occasionally, the effect is quite powerful. But once it becomes a normal department, it will be troublesome. Either it's a group of doctors who are average in their disciplines hanging out together, or it's a group of big shots quarreling every day.

At present, comprehensive diagnosis and treatment is better, that is, it is slightly better in pediatrics, and the development of comprehensive diagnosis and treatment in other disciplines is also the same.

"Okay, the general direction has been determined at present, that is, the gastrointestinal motility is insufficient, so let's come to a consultation in each department. Dean Chen, please arrange a teaching classroom and explain to the family members of the patient. We will ask the experts to check on the spot."

"It's ready, and the family members have agreed." Old Chen has already prepared it. With this kind of work attitude, he can become evergreen, and he definitely has a way.

In the large teaching classroom, patients are lying on the treatment bed accompanied by nurses.

Although the girl is in her early twenties, her height, weight, and development look like a child in her teens.

The girl was afraid at first, but now she saw dozens of people surrounding her, and there was a group of young guys who looked so young, which made the girl feel scared and shy at the same time.

To be honest, the patients in Huaguo are really good. If this is in a foreign country, other patients will ask for it. I have privacy and cannot allow so many doctors to come.

And this little girl, although shy and a little scared, took off her hospital gown with great strength, revealing her fair abdomen and chest.

Zhang Fan looked at the girl's body, and felt deeply moved. This disease must have tortured the girl for a long time.

Because this girl is a little more delicate, she looks like a little doll, and her breasts are not as developed as some fat guys.

The physical examination begins.

"Let me do it, everyone will add!" Zhang Fan originally wanted all the experts to show their hands to the interns, but when he saw the patient's body shivering like a kitten, he suddenly said something.

"Don't be afraid, we are all doctors, we will find your cause and make you healthy." Zhang Fan said softly.

The girl seemed to believe it very much, she bit her lip and nodded lightly, the tense muscles were also relaxed.

"Okay, curl your legs, yes, that's it!"

Physical examination begins...