radicalducati Chapter 669
Chapter 669
「669」
Chen Li, the patient's attending doctor, began to describe the patient's condition.
At the same time, the patient's elderly family also complained on the sidelines.
Because the disease is too long and complicated,
So it took 20 minutes to tell the story alone.
"Everyone, speak up..."
Team leader Professor Chen said.
The doctors in various departments nodded one after another.
Some have already started the physical examination process.
Each department and doctor has its own physical examination methods and experiences, and only believes in what they see and judge.
It didn't take long,
Lin Feng began to check his body.
The edematous lower limbs and figure look out of place, and when pressed at the ankle, a small pit is formed.
The patient's lower abdomen is also slightly raised, which seems to have not been mentioned in the medical record just now. Percussion was done carefully to identify ascites. Doctors in the Department of Gastroenterology have also discovered this problem.
Other physical examinations: the same as the patient's complaint.
"Let's make a B-ultrasound... I feel ascites, although not a lot..."
The doctor of gastroenterology said.
Lin Feng nodded in agreement: "In addition to ascites, I feel that the spleen or liver seems to be a little enlarged, do a B-ultrasound to see..."
"Ascites?"
Chen Li was surprised.
"I checked in the morning, but I didn't find ascites..."
Leaning over, I also gave the patient an examination. And then there wasn't much feeling.
Because Lin Feng feels that ascites is a little less, it may not be noticed by doctors who are not in this specialty.
Professor Chen: "Let me take a look..."
Then Professor Chen percussed for another 2 minutes, also suspicious.
However, the advice of Lin Feng and the gastroenterologist needs to be respected.
"Push a bedside B over..."
soon
A nurse pushed the bedside ultrasound into the ward.
soon
The results came out.
Mild ascites...
In addition, an enlarged spleen was diagnosed ...
At this time, Huadian appeared.
Dr. Lin and the gastroenterologist naturally welcomed many respectful eyes.
Strength, will be respected!
Professor Chen: "Now a new problem has been discovered - liver ascites, enlarged spleen... Do you have any new ideas? "
At this point,
Professor Chen smiled.
Because, he has found the answer.
And Lin Feng also found the answer and smiled.
Another doctor, a neurologist who also smiled.
"It seems that some doctors have found the answer."
"That's right."
"The answer is already a bit obvious."
Professor Chen, Lin Feng, and the neurologist looked at each other and smiled.
Other doctors: ".............................."
What are you doing?
We haven't figured out what the disease is!
Don't sell it, hey!
Lin Feng smiled and said, "Professor Chen, you can announce the answer..."
The neurologist nodded: "Announced by Professor Chen..."
Professor Chen smiled: "Well..."
"According to the monism of our doctors, all diseases may be caused by only one disease..."
"I think that the patient's disease should be "Poems syndrome"..."
Poems syndrome??
After hearing this, the gastroenterologist suddenly realized.
"yes, Poems syndrome, why didn't I think of it?"
Other doctors: "????? "
Why I still didn't understand!
Professor Chen said to Lin Feng: "It's better for Dr. Lin to explain, Dr. Lin as an emergency general practitioner, should know more than me..."
Lin Feng smiled: "Then I will be disrespectful..."
"POEMS syndrome, the word POEMS consists of a series of pathological initials:
P: Polyneuropathy
O: Organomegaly
E: Endocrinopathy
M: M protein (Monoclonalprotein)
S: Skin changes
"
"First of all, the patient's lower limbs are swollen, numb, and painful, which is undoubtedly peripheral neuropathy, and at first we considered whether it was caused by diabetes... But it can also be explained by POEMS. "
"Then the patient edema, at first we thought it was cardiogenic or hepatogenic, but it can actually be explained by POEMS."
"In addition, there are ascites, multiple endocrine lesions (hypothyroidism, etc.) indicated by various examinations, and enlarged spleen, all pointing to POEMS syndrome."
"By the way, there is one last one: some patients with POEMS syndrome will have manifestations of depression, which happens to be the same as the symptoms of patients."
"Taken together, all the patient's symptom clues point to ————POEMS syndrome!"
Lin Feng reasoned and analyzed,
Methodically!
The chain of evidence is clear!
And also in line with monism!
The doctors nodded.
"In this way, there is a 99% chance of POEMS syndrome!"
Be completely convinced!!
Professor Chen instructed the tube bed nurse next to him: "Call the hematology department, say that there is a suspected Poems syndrome patient here, let them come and consult..."
Because of this disease, the treatment still depends on the hematology, so it is reasonable to let the hematology people come up for consultation.
In a few minutes,
The doctor from the hematology department came up.
Then, judging from his experience, it should be "Poems syndrome".
"Do a few checks and see... As long as the test results are confirmed, he will be hospitalized in the hematology department..."
The rest of the checks,
Lin Feng didn't care.
Farewell, leave.
Return to the emergency department.
......
The next day, all the results of this patient's examination came out.
Confirmed: "Poems syndrome"!
The patient was then transferred to the hematology department for anti-plasma cell therapy.
......
Case summary: dark skin, edema of the lower limbs, enlarged organs, weakness, numbness... Then conventional treatment has no effect, and you can consider inferring "Poems syndrome"...
......
......
At this point,
Liu Shenhong, a doctor in the Department of Obstetrics and Gynecology, also encountered a patient that made her confused.
It's so special!
Through the patient's 'illness', she deduced that the patient (wife, expectant mother) was cheating!
Here's the thing:
Last two weeks, she saw a special pregnant woman.
Patient (expectant mother), Miss Liu, 26 years old...
..