When a doctor opened a plug-in

The bedside ultrasound of the emergency department came soon, but no obvious problems were found. The appendix, gallbladder, kidney, and ureter were all good.

The liver, gallbladder, pancreas, spleen and kidney look normal too!

Considering that the girl has no history of binge eating, and the painful part is not mainly on the left side, it should not be acute pancreatitis.

Is it appendicitis?

Acute attack?

Appendicitis cannot be seen by ultrasound unless it is a long-term chronic inflammation that persists and has formed a severe abdominal inflammatory mass.

Chen Cang continued to inquire about the disease history in detail.

"Do you feel metastatic abdominal pain, that is, from the upper abdomen, then gradually transferred to the umbilicus, and transferred to the right lower abdomen?"

The girl seemed to have an opinion on Chen Cang, and her mood was not very good when she spoke.

Chen Cang was a little helpless.

When my mother saw this, she suddenly said, "Nini, speak well and cooperate with the doctor. Can the doctor treat you badly?"

The girl shook her head: "No such situation."

Chen Cang thought about it: "Let’s do an abdominal CT to see if there is any possibility of appendicitis!"

The girl gave Chen Cang a white look and sneered: "Can you do this for a while, do that for a while, you lie to my family's money!"

The parents quickly apologized: "I'm sorry, doctor, in fact, we have long wanted to do an individual examination on our children, so let's do it!"

Fortunately, the parents actively cooperate, and the inspection can continue.

The girl was reluctant anyway, but she was still dragged by her parents for abdominal CT.

The CT was done and no major abnormalities were found.

It is not acute appendicitis, nor does it have bile duct stones, cholecystitis, cholangitis, pancreatitis, intestinal obstruction, gastrointestinal perforation, etc.

Now I am confused about the cause of abdominal pain.

The cause of this severe abdominal pain is just that, and the only suspect now may be the problem of the digestive tract.

Such as gastric ulcer and duodenal ulcer.This peptic ulcer is a very common cause of abdominal pain.

But... If you want to have a gastroscope, Chen Cang is now very worried about the girl's non-cooperation.

And now it is really impossible to diagnose what is going on.

At this time, the girl's father's phone rang, got up and went out to make a call, then came back and hurriedly sent the test sheet and video materials to the other party, and asked Chen Cang some professional questions.

After Chen Cang explained, the man took the phone and walked out.

After a few minutes, the man came over and said: "Doctor...can you check a gastroscope and colonoscopy for us?"

"That's the case. I also consulted my friend who was a doctor in the capital during this period of abdominal pain. He is an expert in gastroenterology. He suggested that I have a gastroscope and colonoscopy to see if there is any change."

It is more convenient to make an appointment for a gastroscope in an emergency department. An appointment for a gastroscope in a gastroenterology department definitely requires a gastroscopy room number. However, it is more convenient for an emergency department, but the charge will be more expensive.

Chen Cang looked at the girl and suggested to go to the gastroenterology department for a hospital examination, and he could also be reimbursed.

As a result, the girl’s parents quickly refused as soon as she was hospitalized.

The other party didn't seem to care about the money, so he wanted to diagnose it as soon as possible.

Gastroscopy is more difficult, the girl was more resistant at first, but later reluctantly agreed to do it because of the parents' lust.

The result of the gastroscopy came out, a little superficial gastritis, and there is no major problem, but this is definitely not the cause of the abdominal pain.

If the girl can barely accept the gastroscope, the reaction of the colonoscopy will be severe!

After the girl's mother thought about colonoscopy, she quickly discussed with her father.

The two suddenly decided to do it!

However, before that, the girl’s mother found a gastroscopy room to prepare for the female doctor who was doing colonoscopy, whispered a few words, and secretly stuffed some red envelopes, hoping that she could take a look at the time of colonoscopy... ...Is there any damage!

The colonoscope came out, and there was still no obvious abnormality.

There is no enteritis, no colon lesions, and no tumors.

Although there is nothing unusual, the girl's mother is obviously a little angry...

It seems that the reason for the anger is not because of abdominal pain, but because of the report of the female doctor.

"Your girl may have had it, but... there is no guarantee. After all, there are still a lot of damage caused by various reasons, so don't worry too much."

After the examination, the girls' parents were rather angry.

But at this time, the girl suddenly had abdominal pain again!

Holding his belly, yelling.

In the observation room, Chen Cang also had no idea.

It can be said that all inspections that can be done are basically done.

But now there is nothing unusual, which is too unscientific!

Abdominal B-ultrasound, gynecological color ultrasound, abdominal CT, gastroscopy, and colonoscopy were all done, but the problem of abdominal pain was not found.

There are so many things in the stomach, and the entire digestive tract is so long. The gastroscope can see part of the digestive tract, and the colonoscope can see the lower part.

Could it be... the invisible part except the problem?

That is, the digestive tract, jejunum and ileum. There is no way to see this. Could it be that there is a problem here?

Be a capsule endoscopy?

Chen Cang also wants to know now, where the evil spirits are.

I haven't seen this strange abdominal pain for a long time!

But looking at the girl's state at this time, Chen Cang felt that it was awful!

Capsule endoscopy can see the entire digestive tract, that is, let the patient swallow a camera the size of a capsule. The camera will walk around the gastrointestinal tract, taking pictures continuously, transmitting data to the computer, and finally pulling it through the stool come out.

If there is a problem with the small intestine (jejunum, ileum), then capsule endoscopy is helpful.

But this check is very expensive!

The endoscopy room of the second hospital of the province can do it, but it has to be several thousand. Inpatients can be reimbursed, but this kind of emergency...

At this moment, Chen Cang suddenly turned around and found that the corners of the girl's mouth twitched, her eyes dull and dull!

!

Chen Cang was shocked!

What's going on here?

However, this situation came and went in a hurry, and it passed quickly.

This signal shocked Chen Cang.

Suddenly thought of a possibility!

He looked at the girls and women: "Excuse me... Do your family members have epilepsy?"

When these words came out, the two shook their heads quickly: "No, no epilepsy..."

Chen Cang continued to ask, "Does she have any trauma history?"

The girl’s father suddenly realized: "Yes! This, yes, in July, she fell down on a bicycle during summer vacation and bumped her head. At that time, she was dizzy for several days. She had a cranial MRI and CT and said it was nothing. It may be a slight concussion."

Chen Cang said quickly: "I now consider your girl's performance may be epilepsy!"

The woman was shocked when he said this!

Epilepsy is not a good disease!

That's Sheep Madness!

To put it bluntly, before in the countryside, it was a disease of being cast aside and laughed at.

There is a sheep in someone's family who is crazy, say it... it is difficult to find a target!

So the woman was a little scared: "Doctor... are you kidding? How can epilepsy have a stomachache? Isn't it twitching and foaming all over?"

Chen Cang shook his head: "I just suspect now, because there is a kind of epilepsy, the main manifestation is abdominal pain!"

"When a seizure occurs, it may be accompanied by autonomic seizures. It is also called diencephalic epilepsy in medicine. The specific types can be headache type, abdominal pain type, limb pain type, syncope type or cardiovascular seizure."

"So, so many tests have been done, I now suggest that we take an EEG to see, and try to find the cause."

The girl's parents were very reasonable and quickly agreed!

Typical epilepsy is indeed mainly convulsions, disturbance of consciousness, and foaming at the mouth. Everyone understands.

However, atypical epilepsy may manifest as abdominal pain, because the abnormal discharge of the brain may be related to the nervous disorders in the abdomen, causing abdominal pain.

Although such examples are rare, there have been!

Otherwise, it won't be written in the textbook.

So when Chen Cang saw the girl having absentia, he suddenly thought of this possibility.

Very rare cases have greatly increased Chen Cang's interest.

The parents took their children directly to the electroencephalogram room and temporarily pulled an electroencephalogram.

Compared with the electrocardiogram, the EEG is slower, but Chen Cang estimates that if it is epilepsy, it will definitely be found.

Because the girl has had several seizures today, and there were minor seizures just now.

Soon, the EEG results came out!

Chen Cang looked at the waveform graph, not very good at interpreting...

And the doctor who checked said: "Dr. Chen, have you seen it? These 3 seconds of spike-slow wave synthesis, and bilateral symmetrical synchronization... This is a typical EEG manifestation of a small seizure!"

Hearing this, Chen Cang was overjoyed!

Finally found the reason!

EEG examination has a decisive role in the diagnosis of epilepsy.

And now, the truth is revealed.

Li Yan from the examination department was a little surprised: "This is the first time I have seen such a patient!"

Now that the reason was found, Chen Cang called the neurology department and requested a consultation.

After Zhang Lingyun heard this special medical record, he hurried down.

"Xiao Chen, I have seen such a patient for so many years, that is, when I was in school! I didn't expect to meet again!" Zhang Lingyun was a little excited.

It was diagnosed as epilepsy. The girl’s parents still care about what to study, ask for leave and go to the neurology department for hospitalization.

ps: Write two or three points, about 15,000 words, please support!

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