Doctor of Healing

Chapter 314 Doctor Xiaoji and I Think
"Spinal canal stenosis is very common in our orthopedics department. Most patients do not need treatment, because vertebral body surgery is relatively difficult, and no one wants to do it without absolute certainty." Deng Chaohong saw that Ji Xiang communicated well and was not stubborn, so he went Turn on the teaching mode.

His teaching mode is different from that of the system NPC, and it is not verbose. It may have something to do with his age and Deng Chaohong's personality.

Ji Xiang listened carefully, and Deng Chaohong took advantage of the patient's time to pick up the film to tell Ji Xiang more.

His basic skills are solid, and the operation is also good, otherwise Director Zhao Jixiang would not have sent his son to Deng Chaohong.

Ji Xiang listened with gusto.

About 10 minutes later, the patient limped back with the film in hand.

"Professor, I'm back. Here's a film for you to see." The patient came back with a film bag and handed it to Deng Chaohong.

"You will know what spinal canal stenosis is after watching the film." Deng Chaohong smiled, full of the teacher's demeanor, full again.

"click~"

The film is inserted into the film reader.

Deng Chaohong glanced at it, and was startled.

I actually "guessed" wrong, the patient is not a problem with the spinal canal!

There are cord-shaped and tortuous abnormal space-occupying shadows in front of the spinal canal. Both T1 and T2 weighted images showed low signal, distributed behind the L4~S1 vertebral body, and the L4/5 gap was obvious. The two longitudinal arches of the venous plexus are dilated, located on the ventral side of the dura mater, forming a specific imaging manifestation of "spectacles sign".

The very typical "glasses" sign appeared. Professor Deng stared at the "glasses" on the film in a daze. After a few seconds, he tried to recall what he saw during the physical examination.

The physical examination process was not difficult. There was joint pain and no other neurological symptoms in the limbs, which were consistent with the clinical signs of spinal stenosis.

but!

Deng Chaohong thought of the question that Ji Xiang had just been "trained" by himself.

"It's not spinal stenosis, it's a problem with blood vessels." Although Deng Chaohong didn't want to admit it, it was meaningless to hold on to death.

Deng Chaohong didn't think about how to choose between his face problem and a true diagnosis and corresponding treatment.

How to choose, isn't it very clear?
"Our local doctors didn't understand it." The patient said hopefully, "They asked me to come to the provincial capital to have a look."

"You sit on it."

Deng Chaohong heard what Jixiang said to the patient more than ten minutes ago.

He felt that his old face was a little red.

But what else can I do if I make a mistake in diagnosis?
It should be because of a rare disease. It is also a good choice to continue the physical examination following Ji Xiang's train of thought. Deng Chaohong comforted himself.

The patient takes off the socks.

Just as he was taking off his socks, Deng Chaohong's eyes widened in surprise.

The patient wore a pair of black socks, but there was almost no difference between taking them off and not taking them off.

Even taking off the socks gave Deng Chaohong the illusion that the patient was wearing another pair of socks inside the socks!

wrong!

As a doctor, Deng Chaohong immediately felt that something was wrong.

But what was wrong, he couldn't tell.As for the discoloration of underwear and socks, it is even rarer than a rare disease. Few of the patients we see usually have a brain missing to this extent.

"I wash my feet every day, and I don't know why the socks are fading, really." The patient said indifferently, "Professor, do you need me to lie down?"

"En." Deng Chaohong nodded absent-mindedly.

Seeing that Ji Xiang didn't speak, he began to check his body.

A few minutes later, Deng Chaohong went to wash his hands, "Is your blood sugar normal?"

"Normal, I don't have diabetes."

According to the description in the book, the patient's condition is called pigmentation on the boots, which is extremely rare, and Deng Chaohong himself has only seen it once or twice.

What is the diagnosis?Deng Chaohong tried his best to find the remaining fragments of memory in his mind.

"Don't you have a stomachache?" Ji Xiang asked suddenly.

Belly, belly...

Ji Xiang's question was like a flash of lightning, and Deng Chaohong immediately thought of a patient he met when he went to the consultation several years ago.

Finally, the patient should have received the Department of Vascular.

"It doesn't hurt." The patient grinned.

Although Jixiang is a young doctor, he still gives enough courtesy and respect.

"Xiao Ji, what are you thinking about?" Deng Chaohong, like the patient, also gave Ji Xiang full respect.

He never thought that Ji Xiang was just a training student, and which training doctor could break so many records in knotting.So this time, Deng Chaohong was as good as he was, and knelt down immediately, ready to hear what Ji Xiang had to say.

"Why do I feel like Budd-Chiari syndrome." Ji Xiang said the diagnosis given by the NPC when he went to the operating room of the system for advice.

"Uh..." Deng Chaohong was taken aback, and then said, "You, lie down and expose your belly."

The patient was a little surprised, but he still lay down according to Deng Chaohong's words.

When the clothes were lifted, several thick veins on the patient's stomach were winding like worms, and they seemed to be still moving with the blood flow.

Enlarged veins, pigmentation on the boots, these key words and the MRI images all reminded Deng Chaohong that the patient was definitely not a simple spinal stenosis!

"I'll make a phone call." Deng Chaohong patted the patient and signaled him to get up.

"Professor, what's the call?" the patient asked.

"Ask someone else for consultation. Your current condition should not be a disease of our orthopedics department." Deng Chaohong tried his best to contain his inner emotions, and gently explained to the patient, "Don't worry, there is a high probability that you will have a definite diagnosis when you come to the Second Affiliated Hospital. "

Patients are very pleased.

Toss hundreds of miles, dozens of days, for a correct diagnosis.

Deng Chaohong turned and left, and looked back at Ji Xiang when he was about to leave.

A few minutes later, Deng Chaohong came in with Director Wang of the Vascular Department and Director Zhao Xiangming of the Interventional Department.

"I...and Dr. Xiaoji suspected Budd-Chiari syndrome." Deng Chaohong said.

"Don't have a stomachache? Do you have to come to your orthopedics department? Does the patient have spider-man signs?" Zhao Xiangming asked.

After entering the door, Zhao Xiangming glanced at the patient, and smiled, "Probably not. I watched the NBA draft more than ten years ago. There was a big, tall, long-armed and long-legged Spider-Man. I think if his belly was a little bigger, he must be Buga. Syndrome."

Is it KD?Ji Xiang smiled, and what Director Zhao said was really similar.

Even though he said so, Zhao Xiangming went to check up immediately.

In addition to no symptoms of abdominal pain and chronic ulcers, the patient had thick and meandering distended veins on the chest and abdomen, pigmentation in the boot area, and a small amount of fluid on percussion in the abdominal cavity.

"I took the patient away. Budd-Chiari syndrome is not common, but the operation is very simple." Zhao Xiangming comforted the patient.

"That……"

"Go with Director Zhao." Deng Chaohong personally sent the patient and Zhao Xiangming away.

This disease belongs to the interventional department, and Deng Chaohong is also very pleased to have found a suitable department for treatment for the patient.

(End of this chapter)