When a doctor opened a plug-in

The young couple who sent the old man is not a native of the capital.

The old man's name is Zhao Kai. He is 77 years old this year. His wife left seven or eight years ago and lived alone.

There are two sons and two daughters, both in the capital.

When the old man was young, he was able to open a factory in Langfang and made a lot of money.

I also tossed a few houses in the capital, catching up with a good time.

The houses in the past were small square meters, and a family of six could not live in them. At that time, large flat floors were not popular. The elderly bought a community with two houses on one floor, which undoubtedly made it much more convenient.

I really want to say that there is money, but not so rich.

After the child got married, the house was given to the child, and he left the old house to live in.

Firstly, it is the old community, and his sons and girls do not look down on it. Secondly, he also knows in his heart that when his children are older, they don't like to guard him.

After his wife left, the old man simply cleaned up the house, vacated a house and rented it out, otherwise he would have no moral character, which would be troublesome.

But the renting out caused trouble. First, the boss came back and cried, saying that the grandson is going to study abroad, and the new house bought by the family has to be repaid and the economy is strained.

The old man felt soft, thinking that anyway, when he grew old, it was them, so he asked the tenant to pay the rent directly to his son.

The second child also knew about this, and the two girls also came.

After a fight, the father was helpless, so he could only collect the rent for one year for the two sons in turn.

Once this involves money, it is a big problem.

In the first two years, the old man had a boring life alone, and an old friend was going to introduce him to a wife.

He said that this person should not be too lonely when he is old, and it is easy for a person to leave early.

After such a discussion, a few old friends are ready to introduce an old lady to the old man.

Such a thing, the old man refused at first, after all... it feels like a second marriage.

As a result, they got along and found that it was pretty good, so the two of them didn't get the certificate, and the two of them lived together, but the days disappeared.

But after being found out by a few children, he came back to talk to Zhao Kai.

"Dad, people are greedy for our house. Our community is in a good location. Every inch of land is very expensive. It costs more than 200,000 yuan per square meter to be demolished!"

"Yes, you can't get the certificate. There are three sons in the old lady's family. It is said that one of them is still unmarried. What should I do if I rely on our family?

"Yes! Dad, you can't be confused!"

"Yes, how sad my mother knows!"

These four people talked and made trouble again, making the old lady who was in her seventies angry and crying and left overnight.

An angry Zhao Kai reprimanded everyone loudly: "You bastards just forced me to die early, right? The best time to die is when the house is demolished, can I still get a demolition money?"

For this reason, the old man fell ill.

But after this incident, the old man and the children are also alienated.

In other words, the children also took the opportunity to alienate the elderly.

However, Zhao Kai has also learned shrewdly since then. He has a commercial pension and a corporate pension, which is a lot of money a month.

He couldn't use it alone, but this time he held it firmly in his hand.

After all, what the old people say is quite reasonable.

Now Zhao Kai can still jump, jump, and move, but seeing these children is afraid that they will stick to it.

...

...

The police contacted the family, but they did not arrive too late.

But the old man's inspection results came out.

Chen Cang pushed the old man to do abdominal CT. As soon as the results came out, Chen Cang was diagnosed with acute pancreatitis.

The CT scan of the abdomen showed that there was a well-defined mass in the second part of the duodenum, the pancreas was enlarged, and the main pancreatic duct was slightly dilated.

This result made Chen Cang and Li Yue both puzzled!

Pancreatitis is certain, but... what is this mass?

Tumor?

Not like!

Li Yue frowned and looked at the radiology doctor: "What's the situation? Tumor?"

The radiologist frowned: "It doesn't look like it, if the tumor...is it so big?"

After Chen Cang saw this, he suddenly said, "Doctor Wang, you can sweep a few more layers on top!"

After hearing this, the radiology doctor nodded immediately!

Before long, the result came out!

The stomach also seems to have abnormal morphology, but it is not clear at all what is going on.

CT NMR is not omnipotent, and what you can see is also limited.

Chen Cang looked at a dozen films in the computer, and suddenly fell into thought!

At this moment, Chen Cang was pleasantly surprised because he discovered a magical thing!

The perfect abdominal imaging + four-dimensional model of the human body produced a magical response!

Chen Cang can even combine the structure of each layer on the film to repay the patient's abdominal cavity.

this moment!

Chen Cang almost jumped up excitedly.

He stared at the four-dimensional map carefully, and then, with the help of the feedback from each CT, he constantly redoed it to form an upper abdominal structure.

at this time!

Time passed by every minute.

Looking at this strangely shaped gastrointestinal tract, Chen Cang suddenly thought of a special disease!

An intussusception of the duodenum and stomach!

This kind of gastrointestinal intussusception is very rare.

Li Yue looked at Chen Cang's expression with joy at this time, and couldn't help asking, "Xiao Chen, what do you see?"

Chen Cang nodded: "Well, I guessed some, but the patient needs to be confirmed by a gastroscope."

Hearing what Chen Cang said, the two turned and stared at Chen Cang, "Oh? What's the situation?"

Chen Cang pointed directly to a few films on the computer and said, "Look, let's watch these five together."

"This may be an atypical manifestation of gastroduodenal intussusception, also called ball valve syndrome, which is a rare disease!

Look here!In fact, it is caused by the prolapse of the pedicled gastric wall into the duodenum."

Hearing this rare disease, everyone was stunned.

Radiologists have also heard of this disease, but they don’t really know much.

But Li Yue is different. As an experienced surgeon, Li Yue frowned and asked, "But, I know the ball valve syndrome, but why does it oppress Vater's ampulla? Also, what is the situation with this bulge?"

Hearing what Li Yue said, Chen Cang took a deep breath, and said sharply, "If I didn't guess wrong... it may be a tumor. Look carefully, this thing is actually different from the signal from the tail. I doubt this. It's a tumor in the tail."

"And this is also the culprit that caused many cases of patients!"

"Gastroduodenal intussusception caused by gastric cancer tends to occur in the distal part of the stomach, mainly in the antrum of the stomach, and less common in the body of the stomach, fundus of the stomach, and anastomoses.

But the downward pull of the intussusception on the duodenal wall may distort and obstruct Vater's ampulla.

The intussusceptible head reaches the second part of the duodenum, so that the patient has a special shape!

This results in compression of Vater's ampulla and is associated with acute pancreatitis and biliary obstruction."

Chen Cang's words directly made Li Yue and the radiology doctor a little confused!

In fact, every imaging doctor is a "modeler"!

They combined the flat CT scan images, and needed to form an anatomical structure map in their minds.

This is more than just a lot of reading ability!

It also requires an excellent anatomical basis, sense of space, etc...

Soon, after the two watched back and forth twice, Li Yue's eyebrows were also stretched out. If he really said to Chen Cang, everything can be explained!

As an emergency surgeon, this kind of diagnostic ability is really too strong!

There is a saying in the medical circle:

What is the best performance of a surgeon?

The answer is: become a physician!

What does that mean?

Physicians are more capable of diagnosis and treatment than surgeons, after all, there are specialties in surgery.

But at this time, Chen Cang insisted on making his diagnostic ability not inferior to that of physicians.

Of course, Chen Cang's ability to watch movies naturally surpasses the "seeing doctor!"

At this time, the radiology doctor couldn't help saying: "Doctor Chen, you are too good!"

"It's better than my professional movie viewer! Any skills?"

Chen Cang coughed: "Without him, only skilled."

...

...

After pretending to be forced, Chen Cang hurriedly took Li Yue to "take" the patient from the CT machine.

After all, the old man now has no family members to help, so they can only do it.

But the radiologist stayed there, always feeling that he had heard this sentence, but he couldn't remember it.

After pushing the old man out, Zhao Kai seemed to have some relief of pain, and couldn't help but said, "Doctor, what's the matter with me?"

Pushing the bed, Chen Cang said, "Don't worry, it's acute pancreatitis and biliary obstruction, so the stomach hurts and the feeling of nausea and vomiting, don't worry."

After hearing what Chen Cang said, instead of relaxing, Zhao Kai sighed.

Suddenly he said slowly and slowly: "Hey... I actually know my situation. I have been eating less for more than a year. Over the past year, I have lost 20 or 30 catties."

"Doctor, don't lie to me. When my wife was alive, she was a doctor. I also knew a lot. I felt that I might have a bad disease."

"Actually, just leave. I'll be honest, I'm not scared. People are scarce in the seventies. I should enjoy the blessings and enjoyment at my age, and I'll see everything I should see!"

Chen Cang heard the old man speak slowly, but did not interrupt.

The rules for speaking for the elderly are very clear, and the education level is quite high.

However, this sad mood is undesirable. Chen Cang simply changed the subject: "Master, you should be quite literate, right? What do you do?"

The old man sighed. Hearing Chen Cang’s question, he couldn’t help but stunned for a moment. He slowly said, “I, I haven’t lived in vain in this life. Later, I saw the founding of the People’s Republic of China on the spot. At that time...I was excited!"

"Follow the chairman, I'm full, everyone started... Later, when the reform and opening up, I was bold and followed the wind, and went to Langfang to open a soda factory, orange-flavored soda. At that time, We have a lot of good sodas in China, Arctic Ocean, Shanhaiguan... and the formula is shared, there is no patent, in nine years, Pepsi and Coca-Cola were bought..."

An old man about to be seventy-seven years old, born in 1933, is really a witness of New China.

Listening to the old man's words, Chen Cang and Li Yue thought that it might be a matter of signing for a while.

It is risky for a 77-year-old man to have a gastroscope. If his family is absent, who will sign?

The elderly should be fine too?

Generally speaking, although the law stipulates, you and your immediate family members can sign!

However, the patient himself, especially the 77-year-old at risk like the old man, even if there is a problem with the signature, the family members still find trouble.

In other words, in fact, sometimes, the patient himself only has the right to disagree with the operation and not the right to decide on the operation.

The elderly now have acute pancreatitis, acute biliary obstruction, and only duodenal intussusception, which may have tumors.

Perhaps many people do not understand why patients can cause acute pancreatitis.

This actually involves an anatomical issue!

The common bile duct and pancreatic duct open in the ampulla of Vater accounted for 80%, and enter the duodenum after confluence!

However, at this time, the high pressure in the duodenal cavity and the compression cause the duodenal juice to flow back into the pancreatic duct, which activates pancreatin to produce acute pancreatitis.

Therefore, this leads to acute biliary obstruction and acute pancreatitis.

In fact, this is the same as autoimmune diseases.

Your own immune cells kill your own tissues and cells.

And this pancreatitis is that one's own digestive juice digests one's own pancreas, causing disease.

In fact, this situation of the human body is really complicated.

After returning, nurse Yang Jie said directly: "I contacted the police station, but... I still can't come now, what should I do?"

A word made Li Yue and Chen Cang a little eager!

It's not coming yet.

At this time, the test results also came out.

Chen Cang took it over and took a look: "The white blood cell count is 17,200μL; the aspartate aminotransferase level is 183UL; the alanine aminotransferase level is 81UL; the bilirubin level is 3.60mgdL; the amylase level is 3686UL."

Basically the condition can be diagnosed clearly.

But... the most important case is acute pancreatitis, biliary obstruction and gastroduodenal intussusception caused by gastric cancer.

Family talks must be conducted.

Chen Cang couldn't help but said, "I'll call as many calls!"

Yang Jie reported the eldest son's phone call.

Chen Cang struck directly.

After the phone call, Chen Cang said directly: "Hello, you are Mr. Zhao Kai’s son, Zhao Zhiteng, right? I have to talk to you about something. Your father is in a very dangerous situation now. There may be a tumor. I need to complete the gastroscopy and get a medical examination, you have to come over!"

After hearing about stomach cancer, the man was taken aback: "Okay, doctor, I'm right now!"

Chen Cang was stunned!

So talkative?

He had already suffocated his big move and prepared for a long talk, but he didn't expect... it was so simple?

Afterwards, Chen Cang made three or four phone calls next to each other, and they were all notified. As a result, after learning that the old man had stomach cancer, they all came!

Chen Cang was stunned!

Could it be... I also hung up when I called?

After hanging up the phone, Chen Cang shrugged: "All are coming!"

Even the people around looked stunned.

Yang Jie was even speechless: "I'm better than you said, but why didn't I come?"

At this time, the man in the young tenant said: "Because the doctor said that the old man has cancer, so..."

Suddenly, everyone was stunned!

This sentence is very meaningful...

...

ps: Two in one, ask for votes~