Perhaps, his diagnosis direction and all the doctors were deviated.

Whether it was Xu Qiu himself or the discussion during the joint consultation, he ignored a little.

Hepatosplenomegaly.

Everyone only regards liver and spleen enlargement as a chain reaction caused by malignant tumor infiltration or other abnormalities.

but……

If liver and spleen enlargement is not accompanied by the primary disease - it is the real cause!

After thinking about this, Xu Qiu suddenly felt enlightened.

Since the primary disease cannot be found, why not treat the liver and spleen enlargement, which is so obvious, as the mastermind behind the disease?

...

In the ward, Luo's mother tucked a quilt for Luo Qiao. She was about to coax her to bed when she was shocked by Xu Qiu who suddenly turned back.

"Doctor, you are..."

Xu Qiu asked without a word of nonsense: "Have the patient ever been exposed to any animal before the onset of the disease last month?"

Luo's mother thought for a long time, and finally said in a hint: "It's been too long, and I don't remember it."

Xu Qiu decided to be more direct: "For example, stray cats, stray dogs, or have been to camping outdoors, etc."

"Stranded...cat?"

Luo's mother said suspiciously: "Yes, my child likes cats very much. I originally planned to buy one, but there are many stray cats in the community. I thought it would be better to buy them than to adopt them, so I took one back."

Stray cat!

At this moment, Xu Qiu felt a sudden enlightenment.

Previously, no one asked the patient about his medical history of contact with stray cats, whether in the lower hospital or after coming to Linhai First Hospital.ъìqυgΕtv.℃ǒΜ

Even Xu Qiu subconsciously thinks about problems from the perspective of professionals.

Although he realized that it might be related to cats and dogs, he did not ask directly, but simply did an examination for Toxoplasma gondii.

Knowing this answer at this moment makes me feel like I am in a dark and bright future.

"Doctor, is it related to that cat?" Luo Qiao's face suddenly became much ugly.

Xu Qiu had already had a guess in his mind, "I'm sure I'll be together."

After saying that, he prescribed a test that no doctor had considered.

Minimally invasive laparoscopy!

...

Laparoscopy is now Xu Qiu’s strength.

After mastering a lot of interventional experience, knowledge, and master-level laparoscopic surgery skills, he had already had his own experience in laparoscopic surgery and exploration.

Therefore, this laparoscopic investigation, Xu Qiu decided to take action personally.

This case is too tricky, and if it is someone else, it is easy to miss the diagnosis!

In the operating room.

I heard that after I had to do laparoscopy, doctors from hematology and orthopedic surgeons rushed over.

They still couldn't understand the decision.

Is the liver and spleen a victim?

What's the use of examining a swollen liver and spleen?

However, they knew that Xu Qiu often used strange tricks and were all very effective, so they were more surprised!

On the hospital bed, the exploration surgery is about to begin.

First, lie flat, and adjust the automatic carbon dioxide pneumatic abdominal machine to inflate the flow rate of 1 to 2 l per minute to establish an artificial pneumophilia.

Then adjust the head and hips to a high position, the abdomen are routinely disinfected, and the towel is laid.

1% procaine 50-100ml was subjected to periumarial block anesthesia and peritoneal surface anesthesia...

One centimeter from the edge of the umbilical, make a small incision of one centimeter to reach the fascia...

Then lift the peritoneum and place the puncture device along the skin incision!

Bang!

Bang!

After two breakthroughs, I successfully entered the abdominal cavity!

The pneumoplegia machine shows that the intraabdominal pressure is 1.55kpa.

"Infused 2l of carbon dioxide."

Xu Qiu instructed him to insert a laparoscopic body at the same time, connect the light source, and start exploring the abdominal cavity.

First far and then near.

No problems were found.

Xu Qiu put his focus on his liver.

Soon, a cluster of pink structures appeared on the screen, with bright red blood vessels passing by.

It's the liver.

"Nothing unusual..."

"Yes, except for the size, appearance, profile, and surface smoothness, they are no different from normal people."

The doctors spoke, a little disappointed.

Xu Qiu's expression went without any change.

He believed in his judgment.

Hissing-

Xu Qiu operated the laparoscopy and carefully opened the liver lobes, intending to conduct a more thorough examination.

As a result, as soon as I opened a leaf, the screen on the screen scared everyone.

"What's this!"

Below the liver lobe, there are white patch-like nodules on the surface of the liver.

In addition, there are circles of black areas around, which are focal necrosis.

Xu Qiu quickly gave a diagnosis.

White nodules: granulomatous inflammation

Black area: Focal necrosis.

These two manifestations may occur in fungal, bacterial infections, and some rare parasitic diseases.

"But the infection has been ruled out..." The orthopedic surgeon was puzzled.

"Parasite infection?" The hematologist was a little unsure.

Xu Qiu took out the sample and asked the nurse to send it to the pathological biopsy, and said at the same time: "Well, parasite."

"Parasite? Can I check that it has been ruled out?"

Xu Qiu added: "To be precise, cat claw disease."

...

Cat claw disease is a rare infectious disease. It is mostly caused by fleas, ticks and other parasites, and Barton invades the human body, causing the disease.

For people in cities, the infection is mostly through scratching, biting, or accidental contact during forest camping.

There are many clinical manifestations of this disease.

Primary skin lesions, such as red papules.

There are also local lymph node enlargement, fever, nausea, and conjunctivitis.

There are also many rare complications, such as encephalopathy, chronic organ failure and joint damage!

There are too many symptoms and many common manifestations of malignant tumors, so it is also easy to be misdiagnosed as a tumor!

If the pet-ct is really done, the patient will be clear of the changes in the bone density throughout the body, and may be regarded as a malignant tumor...

No one would have thought that there is another cat claw disease, which can also cause infiltration of malignant tumors!

Thinking of this, doctors in the hematology and orthopedic surgeons were all in a cold sweat.

Their diagnosis may be really wrong...

At this moment, they finally understood why Xu Qiu, who could have won a large number of difficult operations, personally took this simple laparoscopic investigation.

If it were another doctor, it might really be missed the white nodules buried under the liver lobe!
To be continued...