Chapter 37
The doctor was very careful.
Drain the effusion, make a diagnosis, and prescribe medical advice.
All in one go.
The doctors in training around him were all stunned.
Boss! Please accept my greeting!
Suddenly, an intern asked boldly:
"Doctor Zhang... why are you so sure that it is bile duct stones combined with cholangitis?"
Zhang Yi glanced at him and asked: "Have you memorized the things you are asked to memorize in school?"
The intern was very confused, and then lowered his head embarrassedly.
He really couldn't remember what this diagnosis had to do with memorizing.
Zhang Yi shook his head helplessly: "What is Reynolds' pentalogy? Recite it for me."
Zhang Yi asked questions like a teacher while taking off his gloves.
The intern was stunned by the question and stood there in a daze.
What?
What is this Pentalogy? !
It seems very familiar!
But I just can't remember it...
Chen Fang only reacted after hearing Zhang Yi's words!
"So you rely on this to make a diagnosis!"
"Reynolds Pentalogy refers to abdominal pain, high fever, jaundice, shock and mental changes. As long as these five symptoms appear together, it must be acute obstructive suppurative cholangitis."
"And acute obstructive suppurative cholangitis can also be called bile duct stones combined with acute cholangitis."
Chen Fang explained to the intern after recalling it.
His diagnosis of biliary pancreatitis just now was simply wrong.
Just looking at the three symptoms of abdominal pain, fever and jaundice, it should be considered as cholangitis.
Combined with Reynolds Pentalogy, it is not difficult to distinguish between ordinary cholangitis and severe cholangitis.
In the end, I didn't memorize enough!
It seems that memorizing more in daily life is really beneficial.
After hearing Chen Fang's explanation, Zhang Yi nodded in agreement:
"Yes, the symptoms of this patient just now add up to this disease."
"If you memorize these key points, you can distinguish these similar cholecystitis, pancreatitis and cholangitis."
The interns and trainees cast their admiring eyes at Zhang Yi.
"We understand, Dr. Zhang!"
They are all trainees, and some of them started their training half a year earlier than Zhang Yi.
I didn't expect the gap to be so big!
Oh!
How can I catch up with Zhang Yi!
Zhang Yi and Chen Fang took the 1,000 milliliters of black ascites and found the family members waiting outside the door.
The family members were panicked when they saw the bag of black water.
"Isn't this drawn from my mother's stomach?" The family members asked first.
Zhang Yi nodded: "Yes, your mother was diagnosed with gallbladder or bile duct stones a long time ago?"
The family member's eyes flickered a few times and then replied with shame:
"Last year... it was diagnosed, but at that time my family was really poor and there was nothing we could do. My two children were sick and we were in urgent need of money..."
"Then my mother took some anti-inflammatory drugs casually, and then she said she was fine... So I thought she was not serious... Woohoo... I thought she was not serious..."
The family member was a little girl in her early twenties.
It's not easy to be a mother at a young age.
Zhang Yi sighed and said:
"Your mother was diagnosed with kidney stones last year. It is impossible to get better by taking anti-inflammatory drugs alone. She must have had frequent abdominal pain and fever this year. But she has never said it for your own small family and two children."
"Some things may not be said by me as a doctor, but..."
"You are a mother. You want to give the best to your children, but your mother thinks so too. She doesn't want to drag you down and burden you, so she has been enduring the pain."
"This pain of kidney stones is not something that ordinary people can bear. Look at this black fluid in her stomach. I really don't know how long your mother has endured it."
"Yesterday, she couldn't stand it and came to the hospital. She just went to the outpatient clinic for infusion and didn't come for a comprehensive examination. If she hadn't fainted today, I dare not imagine what would happen next."
"So, go home and see your mother more often, don't ignore your parents after having children."
"It is such a happy thing to have parents in life. Don't regret it when your parents are gone one day."
Others have parents but don't know how to cherish them.
Where is Zhang Yi.
I want to cherish and be filial to my parents, but they are no longer here.
So don’t wait until the wind stops when the tree wants to be still…
After hearing what Zhang Yi said, the family member looked down at the big bag of black effusion and burst into tears.
“Wuwu… Mom… I’m sorry…”
The family members were deeply shocked.
She didn't know that her mother had endured such pain for so long!
Regret, heartache, and powerlessness filled the family members' hearts.
Zhang Yi comforted the family members for a few more words and then returned to the clinic with Chen Fang.
The gout patient just came back.
Looking at the examination list, Zhang Yi shook his head and said, "The uric acid is 510, and there is also your film."
Zhang Yi put the gray-black CT film on the viewing slide while speaking.
"Look here, all the small dots are urate crystals."
The family members were anxious: "Then what should we do? How to treat it? Do we need surgery?"
"Don't panic, the most important thing now is to relieve the pain first. Your tophi are still very small and can be dissolved and metabolized by taking medicine. Remember to drink more water, otherwise it will not be discharged."
Zhang Yi explained to the patient while writing a list.
"Also, you can't drink alcohol anymore, you can't eat animal organs, and you have to have a fixed amount of protein intake."
Swish, swish, swish.
Zhang Yi wrote an infusion form and a gout admission form and handed them to the family:
"Take this to the emergency infusion room next door to find the nurses and ask them to give you an infusion first, and then go to the gout department on the fifth floor of the outpatient department to get hospitalized, understand?"
The family nodded repeatedly: "I understand, thank you, doctor."
Chen Fang sat next to him and watched Zhang Yi see patients.
This guy is getting more and more skilled.
He has only been here for half a day!
...
The next day.
The bacterial culture results of the cholangitis patient came out.
The results of the four culture dishes showed that they were all positive!
My goodness, the inflammation and infection are really serious.
Zhang Yi added ceftriaxone and mefenamic acid, and used them together to fight infection.
In less than half a day, the patient's fever subsided, and his mental state improved a lot.
The family thanked Zhang Yi repeatedly.
At noon, Zhang Yi and Chen Fang were preparing to go to the cafeteria for lunch.
They bumped into a cute little girl.
"Oh my~ It hurts~~"
It was the little girl who bumped into Zhang Yi without looking at the road.
Unexpectedly, the little girl started to scream first.
Zhang Yi laughed and squatted down to ask her: "Where did you bump into?"
Who knew that the moment the little girl looked up and saw Zhang Yi, she did not hide her crazy expression!
"Wow~ So handsome~~ Dad~~~"
Zhang Yi: o_o ? ?
Chen Fang: ÒωÓױ
Oh my goodness, when did Zhang Yi have a daughter? !
Zhang Yi was also confused!
Where did the little girl come from? Why did she call a handsome guy dad?
Several female colleagues in the surrounding departments also pricked up their ears and looked at Zhang Yi with pointed eyes.
Damn, isn't Zhang Yi single? !
How come there is suddenly another daughter?
Do they still have a chance to get promoted? ?
Just as Zhang Yi was about to explain, a familiar voice came from behind the little girl.
"Xixi, don't joke with Dr. Zhang, call me uncle."
Zhang Yi looked up and found that it was Wang Chuchu.
He counted with his fingers and found that it had been almost a week since Wang Chuchu had a hysterectomy.
Now she was walking towards him slowly in a hospital gown.
She looked like she had recovered well.
But after all, it was a major operation, and she lost a lot of weight.
But she was still very beautiful after losing weight.
"Hehe, hello Uncle Zhang~~ My name is Wang Xiyue~~ I am five years old this year~"
The little girl said proudly, holding her five chubby little fingers.
Zhang Yi pinched her pink cheeks and smiled, "You're so naughty at the age of five."
"Doctor Zhang, the doctor upstairs said that I'm recovering very well and may be discharged in one or two days.
Thank you so much for my surgery. I heard from the gynecologist after I woke up. I had a heavy bleeding during the operation, and you rescued me..."
"It's okay. As a doctor, it's normal to perform surgery to save patients."
Wang Chuchu smiled and looked at Zhang Yi, hesitating to speak.
"What's wrong? Is there anything else?" Zhang Yi asked.
If you're okay, I'll go eat first, beautiful lady.
I'm hungry!
Wang Chuchu bit her teeth lightly and asked with a slightly red cheek:
"After I'm discharged from the hospital, I wonder if I can treat you, Doctor Zhang, to a meal?"