This is a symptom that cannot occur naturally...

The only possibility is man-made.

Shi Lian couldn't wait any longer: "Teacher, I'm going to ask about the medical history!"

Xu Qiu nodded.

After a while, she came back with a wry smile.

"Teacher, I understand..."

"what's the situation?"

"Plum Blossom Needle. Their old prescription doctor said that there was something wrong and her legs were always swollen, so they asked someone to give her a dozen plum blossom needles."

It turned out to be a plum blossom needle...Xu Qiu understood.

This is a traditional Chinese medicine method, also called skin acupuncture.

The instrument used is a row of short needles shaped like plum blossoms. Because the needles are very shallow, they can prick the skin without hurting the flesh. They belong to the cluster needle shallow needle method and are an advancement of the ancient "half needle" and "floating needle" acupuncture methods.

Therapy has a wide range of applications.

However, its main function is to stimulate the body surface, relieve headaches, insomnia, etc., and its use to treat edema is still rare.

"Skin petechiae can be ruled out..."

So where do these inflammation markers come from?

Xu Qiu fell into deep thought.

At this time, he found another reminder in the medical record.

The patient has a history of constipation...

In other words, Xie Yunshi suffers from frequent constipation?

He quickly retrieved the patient's abdominal CT film, looked at it carefully, and found that there was a mild obstruction in her transverse colon.

The degree of obstruction is so slight that it cannot be found without looking suspiciously.

In other words, even if the doctor notices the impact, he probably won't care too much.

This level of obstruction is not an organic disease and is not enough to cause disease, so there is no need to pay attention at all.

But combined with constipation, the situation is different.

"It's not a problem with the transverse colon..."

Xu Qiu looked at the surrounding organizations.

After a few minutes, he finally found the problem.

The patient's retroperitoneal fibrofatty tissue proliferated abnormally, and some tissues began to develop fibrosis.

"Retroperitoneal fat hyperplasia, fibrosis?"

Xu Qiu's eyes lit up...Isn't this retroperitoneal fibrosis RPF?

RPF is a rare disease that is a non-specific non-suppurative inflammation.

Idiopathic RPF is related to excess autoimmune reactivity or allergic diseases.

The patient has autoimmune hepatitis, which is most likely due to retroperitoneal fibrosis. It is precisely because of RPF that Xie Yunshi experienced an increase in various inflammatory indicators.

Constipation occurs precisely because when the peritoneum thickens, the pressure in the abdominal cavity increases, and the intestinal tube in the abdominal cavity is squeezed...

…

"What's the cause of the coma?" Immediately afterwards, Xu Qiu began to explore the next symptom.

He looked back at the patient's cardiac ultrasound.

The imaging doctor only gave two results, but there are more things that can be seen in the ultrasound image.

For example, the right side of the heart is larger...

Combined with the patient's own condition, there is a high probability of pulmonary hypertension.

Although no thrombus was seen in the main pulmonary artery, what about the subsegments?

If there are blood clots in those places, causing subsegmental pulmonary embolism, it may also lead to the current situation.

The second is liver failure.

This is Xie Yunshi's old problem. If she has developed to the stage of liver cirrhosis, it is likely to cause hepatic encephalopathy, leading to loss of consciousness...

"If the coma is caused by hepatic encephalopathy, then heart problems can also be explained." Xu Qiu pondered.

Hepatic encephalopathy has developed, and the body will also develop hepatorenal syndrome, which can cause cardiac insufficiency and become the main cause of cardiac enlargement.

Soon, he targeted breathing difficulties.

Although the patient had not experienced dyspnea before, the patient developed this symptom after losing consciousness and waking up, and could only maintain blood oxygen saturation when connected to a ventilator.

This made Xu Qiu keenly aware that difficulty in breathing might be the breakthrough point.

There are only three reasons that can cause difficulty breathing.

1. Pulmonary infection.

This depends on whether there are rales; whether the infection indicator PCT is normal; whether CT indicates lung infection; whether there is sepsis; whether there is severe hypoxia and whether the ventilator can be removed within six hours...

Xu Qiu carefully recalled the details of Xie Yunshi's physical examination.

When she was auscultated at that time, there were indeed rales, and the infection indicator PCT was also abnormal, and the CT also showed infection.

However, sepsis did not occur, nor was it severe hypoxia.

Judging from Xie Yunshi's current situation, it is very easy to evacuate the aircraft within six hours.

After comprehensive analysis, lung infection is basically not the main cause of dyspnea.

So, what about hepatic encephalopathy?

This is what Dr. Wang Pingping is most suspicious of.

However, as soon as he thought of this, Shi Lian answered the phone, and after hanging up, he said to Xu Qiu: "Teacher, the respiratory department and the cardiology department all called and said that this patient is of great learning value and would like you to hold a joint consultation.

…”

"Oh, okay."

Xu Qiu came back from his thoughts... By coincidence, he had made further judgments in his mind, and if nothing else happened, he should have already made a diagnosis.

He looked at the time and saw that there was still more than an hour left before going to work in the afternoon.

Xu Qiu then said: "Let's get them over now."

…

Soon, all departments received invitations for consultation from the emergency department.

Seeing that Xu Qiu had convened the meeting, everyone was very excited.

For other hospitals, whoever holds a hospital-wide conference basically means that there are difficult cases to deal with, and no one will be too happy.

But clinical medicine is different.

Meetings with Xu Qiu present are all for everyone to gain insights...

"It has to be Dr. Xu!"

"Hey, I just said I would apply to the emergency department! I think this case of Xie Yunshi is very typical. Being able to learn from her will greatly train the diagnosis and treatment capabilities of our hospital's doctors!"

"I don't know if Dr. Xu has found the cause. I'm still a little confused now."

"Yes, Xie Yunshi's medical history is too messy. There are too many diseases, but the right medicines don't have much effect. Today, she even lost consciousness. It's troublesome!"

The doctors were discussing.

However, as Xu Qiu entered the conference room, all the doctors, including the heads of departments, immediately became quiet, and their eyes suddenly shifted to Xu Qiu.

"Doctor Xu."

The director and other doctors all stood up and paid tribute.

"Um."

Xu Qiu didn't talk too much and started explaining immediately as soon as he sat down.

Indicators of infection, skin petechiae, and plum blossom needles were all quickly pointed out by him.

Everyone was a little surprised.

"It's actually a plum blossom needle?"

"My God, if you look closely, the shapes of these petechiae are really exactly the same, and there is a sense of order in the chaos. Can Dr. Xu see this?"

"The patient's mental state has been very bad, and he is unwilling to cooperate with our consultation. Even Dr. Xu didn't ask for this detail... but the abnormality was directly seen through the photos!"

"What is the God of Medicine? This is it!"

Words of praise rang out in the conference room, and the directors praised Xu Qiu with proud smiles on their faces.

——
Chapter completed!