Surgical artist

Chapter 148 The Smile Disappears Little by Little
Everyone has read the eight medical records.

Those who can give diagnostic opinions already know it in their hearts, and the rest are basically uncertain and unable to draw conclusions.

Section Chief He: "Then, enter the next stage, the hospital team will communicate and discuss, comprehensively consider, and give the final diagnosis opinion."

According to the order of the medical records, everyone began to discuss.

Obviously, everyone has participated in it many times, and they are familiar with it, so they immediately started discussing, publishing, and giving diagnostic opinions.

Zhao Peiru observed it.

The two low-level hospitals spoke the least, and the two middle-level hospitals occasionally made a few key comments.

In the end, most of the people who made the final decision and gave a diagnosis opinion were the deputy director Shi of the first-class Huakang Hospital.

Occasionally, the cancer hospital or Nanxi Hospital will give a diagnosis opinion.

And Zhao Peiru basically didn't say much during the whole process.

Just listen quietly.

"These medical cases are really too simple."

Zhao Peiru shook his head inwardly.

It is said to be a "difficult disease", but after working together, a group of people discuss together, and after eliminating all kinds of impossibilities, they will finally come to the "correct answer".

And even if it is difficult to diagnose at the moment, everyone can give a general direction, as long as you go back and do further examinations, you can basically diagnose it.

It has to be said that the level of these provincial hospitals is still good.

Zhao Peiru was disappointed. Could it be that today is a waste of time?

The two young men behind him, Xiao Meng and Xiao Mu, could hardly hold their heads up in front of the aura of these provincial hospital bosses.

Especially since Zhao Peiru didn't speak, the two of them didn't dare to make any movement. They sat quietly behind, completely learning the attitude, sitting obediently.

Following each case, it was diagnosed...

The smiles on everyone's faces gradually increased.

Solving "difficult diseases" is a great sense of accomplishment for doctors, and even a sense of refreshment.

Like a student who finally solves an Olympiad problem.Just like a game competitor, he finally broke through the difficulties of the world.

The sense of accomplishment is very strong!Very cool!

The atmosphere in the small meeting room gradually became more relaxed.

And Director Shi of Huakang Hospital, who solved the most problems, naturally became the object of most conversations.

"Director Shi has excellent medical skills!"

"I think, under the leadership of Director Shi, we can solve all these difficult diseases today!"

Everyone's confidence is high.

There are also smiles on their faces.

"I heard that last week, the five hospitals where they were on duty in turn failed to solve all the difficult diseases, leaving several difficult problems!"

With such a comparison, the smiles on everyone's faces are even more.

Even Section Chief He, who was in charge of hosting, felt that today was relatively smooth.

The only pity is that Zhao Peiru's team, who applied for it on his own initiative, has not performed outstandingly.

However, innocuous.

The ultimate goal of regular joint consultation is to diagnose the case, as long as this goal can be achieved.

Section Chief He glanced at Huakang's Director Shi and praised him.

Most of the medical cases this time were solved by this person.

It seems that this kind of consultation really requires a heavyweight director of a large hospital to sit in charge.

Doctors from such a large hospital are well-informed, have seen various difficult and complicated medical cases, and have rich experience, so they are naturally handy in diagnosis.

"Okay, the last two medical records are left."

Chief He also had a smile on his face.

It seems that today can end early.

The penultimate case was not difficult either.

As soon as everyone discussed it, they quickly gave a diagnosis direction, and based on the patient's medical history, two possibilities were quickly diagnosed. After going back to the patient for a further examination, one can basically be ruled out, and the final diagnosis is made.

Arrived at the last one.

Zhen Haifeng, the director of liver surgery at Nanxi Hospital, said, "Let me explain this case."

"This is a patient of our Nanxi Hospital. The hospital has been discussing it, but it has not been diagnosed. I hope Director Shi and colleagues can help us give us advice."

Everyone smiled and nodded.

The previous seven medical records gave everyone a lot of confidence.

"The patient in this case is 66 years old and female. She complained of pain in the upper right abdomen, which has lasted for a month."

"The initial diagnosis at our outpatient clinic was right lobe cancer of the liver."

"The main basis is the following inspection results..."

Zhen Haifeng explained the patient's condition again: "The patient has a mass in the upper right abdomen, and CT also shows a massive tumor in the right lobe of the liver, the upper part of the common bile duct is compressed, and the upper part of the hepatic duct is dilated..."

"finally."

"We consider its clinical characteristics, which is a bit like a tumor in the right lobe of the liver, and a bit like a small round cell tumor."

As soon as she finished speaking, someone shook her head.

"It can't be a small round cell tumor."

"Small round cell tumors usually occur in teenagers, up to 20 years old. This patient is already 66 years old. How is it possible? There is no such precedent in our province's medical database. .”

The others also nodded.

This "small round cell tumor" is a "young disease", especially in the "soft tissue" part like this case, which can only be seen in young people.

In the provincial database, the oldest sick patient is also 34 years old, and that is also an exception.Most of them are still around 20 years old, most of them are 16 or 17 years old.

Therefore, the first thing everyone ruled out was small round cell tumors.

Zhen Haifeng smiled wryly and said, "We Nanxi also considered this way, but this pathological feature is a bit reluctant to say that it is a tumor in the right lobe of the liver."

Everyone discussed for a while.

For a while, the diagnosis could not be made.

First of all, what is certain is tumor and cancer.However, there is disagreement about what kind of tumor it is.

If this kind of diagnosis can be made correctly, then it is possible to completely cure the disease when the condition is the mildest.

But if it is misdiagnosed, after that operation, it will often relapse, and it will be re-admitted to the hospital again. Repeated operations will eventually delay the condition... In the end, the patient can only use conservative palliative therapy. The consequences are dire.

So the correct diagnosis is very important!
Why doesn't everyone know this?
They discussed in depth, but also wanted to identify the pathology and find out the "correct answer".

Can……

Following the discussion, the smiles and confidence on everyone's faces disappeared little by little.

In this conference room, the kind of "strategy" just now, the ability to rule out various wrong directions after a short discussion, then determine the correct direction, and finally diagnose the decisiveness seems to have suddenly disappeared!
In the end, all eyes were on Director Shi of Huakang Hospital.

Director Shi also kept staring at the medical record, but didn't speak for a long time.

"According to the pathological features, it does look like a small round cell tumor."

"However, I have really done research on this small round cell tumor for a while."

"I have read the literature on this malignant small round cell tumor in the past 20 years. I have also done in-depth research on the pathological characteristics of the tumor in the right lobe of the liver."

As soon as these words were said, everyone's eyes lit up!
Director Shi happened to be researching?This is an expert!

When Zhao Peiru heard this, he was disappointed.

Sure enough, these illnesses are too simple to withstand the combined efforts of these provincial experts.

Director Shi said: "Although small round cell tumors also invade, they are generally limited to the serosa and will not invade the organ parenchyma."

"But the tumor in this case should have originated in the liver, and then invaded the antrum of the stomach, the descending part of the duodenum, and the serosa of the hepatic flexure of the transverse colon, which led to the patient's huge mass, abdominal distension, abdominal pain, and nausea. And so on."

Listening to Director Shi's eloquent talk, he deduced the primary site of the tumor and the site of invasion and involvement bit by bit...

Everyone nodded in conviction.

It makes sense!

"So I think that the tumor in the right lobe of the liver should still be considered, and the tumor is likely to have involved multiple organs, and surgery needs to be performed as soon as possible."

Having said that, it is almost time to make a diagnosis.

Everyone has no objection.

At this time, Zhao Peiru finally sat up straight.

The waiting opportunity finally came.

(End of this chapter)