Zhou Can's voice was calm, without any anger.

But it was enough to make Director Jiang feel ashamed and blush.

"Director Jiang, please sit down and take a rest first. I will introduce the patient's basic situation to Dr. Zhou." The chief physician who helped Zhou Can speak twice seemed to be at least in his fifties.

He has a kind face, all white hair, and a thin body, but only his eyes still shine with an intimidating light.

As bright as the stars in the dark night.

"Dr. Zhou, please sit down! This is the patient's examination information and medical history. You can first understand the patient's basic situation. If you don't understand anything, you can ask me. By the way, my surname is Luo, and I am the director of this department.

"

It turns out that this is Director Luo, who is much more approachable than expected.

"OK, thanks!"

Zhou Can took the information and read it carefully.

The patient had a physical examination and found mild tenderness in the right upper quadrant, but no tumor or mass was palpable. The patient felt obvious pain when the area where the liver was gently tapped.

The patient currently has chills, high fever, and jaundice.

Bilirubin was significantly elevated.

The patient underwent multiple examinations, including blood routine, B-ultrasound, and CT.

Considering that the patient had gallbladder stones, the cardiovascular medicine doctors initially suspected that gallbladder contraction caused common bile duct obstruction after gallstones were discharged into the common bile duct, which caused jaundice.

The patient's B-ultrasound results showed that the internal and external bile ducts were not dilated, the pancreatic duct was normal, and there was no significant increase in blood meal enzyme.

Seeing this, Zhou Can relied on what he had learned and could basically rule out the possibility of jaundice caused by common bile duct obstruction.

For jaundice, focus on the gallbladder and liver.

Liver and gallbladder are in harmony, these two organs are a pair of good brothers.

CT showed that the patient's lungs were normal when he was first admitted and there was no obvious inflammatory reaction.

A follow-up CT scan today showed an abnormality in the chest image.

There are cotton wool-like shadows in both lungs.

What does this mean?

Zhou Can immediately suspected that the patient had a lung abscess.

None of the directors of the Department of Cardiovascular Medicine paid any more attention to Zhou Can, but continued to discuss the patient's condition and possible causes.

The chief physician of the endocrinology department basically came here to make matters worse.

Because it does not involve the field of endocrinology, which he is good at, I cannot provide any useful reference advice.

It is probably because this patient has diabetes that the cardiovascular medicine doctors invited him here.

Endocrinologists are often better at treating diabetes.

However, the patient's current symptoms are basically unrelated to diabetes.

This leaves the chief physician of the Department of Endocrinology to sit there and fuss. The key is that the cause of the disease has not been found, and everyone has not yet discussed a result, so he has no way to leave.

Zhou Can continued to check the patient's other examination results.

B-ultrasound review showed that the patient's right lobe of liver was huge and presented as a solid space-occupying lesion.

The B-ultrasound taken before the patient was admitted to the hospital for treatment of cerebral infarction showed that the liver was basically normal.

In other words, all lesions in the patient's lungs and liver occurred after treatment for cerebral infarction.

It is not difficult to understand why Director Jiang was so anxious.

Any doctor would be anxious if the patient he was treating had such a serious condition!

Otherwise, the patient is particularly vulnerable to death.

Especially for patients who are older and have multiple underlying diseases.

"Directors, can I give you your diagnosis?"

Zhou Can raised his hand and asked.

Director Jiang looked at Zhou Can in surprise. He didn't expect Zhou Can to have a diagnosis so quickly. But he didn't hold out much hope.

How good a diagnosis can a graduate student provide?

Director Luo also turned to look at Zhou Can and said, "Please speak!"

"I just went through all the patient's information, and I have a few immature opinions. First, the patient has cotton-wool-like shadows on both lungs. Should he consider it a lung abscess? I suggest taking the patient's sputum sample for sputum preparation.

Culture test. Second, the patient’s right lobe of the liver is huge and has solid space-occupying lesions. I suspect it is also an abscess. It is recommended to perform a puncture to extract the pus under B-ultrasound. If necessary, I can do this puncture."

Zhou Can is sure that if he does this puncture, he will most likely earn 100 experience points as a reward.

"The patient's sputum culture test is already being done, and the results are expected to be available soon. I didn't expect Dr. Zhou to be there for a while." After listening to Zhou Can's diagnostic opinions, Director Luo couldn't help but admire him greatly.

None of the other chief physicians dared to look down upon this graduate student.

"You can propose a targeted examination plan, indicating that the cause of the disease has been diagnosed. Tell us about your diagnosis results! Abscesses may occur in the liver and lungs. We have already diagnosed these. What we need now is the cause.

, try to provide precise treatment to the patient in the shortest possible time.”

Although Director Jiang's tone is still a bit condescending, his attitude has obviously changed.

At least he had taken the initiative to understand Zhou Can's diagnosis.

"The patient was probably infected with bacteria in the blood and developed sepsis. Then because he failed to take medication promptly and accurately, the condition eventually worsened and turned into sepsis."

Zhou Can expressed his diagnostic conclusion.

This disease is actually not as difficult to diagnose as imagined.

I don’t understand that so many chief physicians in the Department of Cardiovascular Medicine have failed to diagnose the cause of the disease. Is it because of their incompetence or is there another hidden reason?

"At first, I also suspected that the patient was infected because of diabetes and developed sepsis during the infusion of antithrombotic drugs. However, blood culture and infusion fluid culture showed sterile growth. Therefore, we ruled out the possibility of sepsis."

Director Hong from the Department of Endocrinology was the first to object.

After Zhou Can heard this, he suddenly realized.

No wonder so many chief physicians failed to diagnose the cause of the patient's disease.

It is very harmful to rule out a certain type of disease by just looking at the test results once.

Sometimes, there is nothing wrong with the first inspection, but there may be problems after a day or two.

At least Zhou Can encountered many similar situations when diagnosing some difficult and complicated diseases.

The biggest fear as a doctor is sticking to the rules.

This can easily blind the eye.

You must have the courage to doubt the test results and use facts to overturn the test results in order to avoid forming a "diagnostic blind spot".

"I have seen the blood culture and infusion culture test reports, which occurred four days ago. At that time, the patient developed high fever, chills and other symptoms not long after the anti-thrombotic infusion. In fact, it was possible that the infection was new at this time and could not be detected.

It’s normal.”

Zhou Can stated his point of view.

"Since we have done a sputum culture test on the patient, even if we don't invite our gastroenterology department to come for consultation this time, we can still find the cause."

As long as the sputum culture test results confirm that the lungs are infected with sepsis, the patient can be diagnosed with sepsis immediately.

"Aren't we worried about the patient's death? The patient's illness has been going on for four days and is getting worse every day. I'm as anxious as a cat scratching my head." Director Jiang's attitude towards Zhou Can completely changed.

He even took the initiative to explain why he was so anxious and angry.

The red director of the endocrinology department was still a little stubborn and said, "It's hard to say whether it is sepsis. There are many diseases that cause symptoms similar to sepsis in the lungs and liver. I have seen patients with liver cancer who have had similar symptoms."

.”

This kind of hard-nosed argument is actually very feeble.

It's nothing more than trying to save a little face.

There are many old doctors in the hospital like Director Hong, who are used to being pampered and pampered. They are flattered every day and all kinds of flattery can make their ears feel numb.

After a long time, it is easy to make people feel dizzy.

Once the face goes up, it becomes difficult to think about it.

Director Hong is a typical example. Even though he knew Zhou Can's diagnosis was likely to become a fact, he still made excuses for the sake of saving face.

"Similar symptoms may indeed occur in other diseases. Director Luo, do you think you can perform a liver puncture on the patient and extract the pus for further diagnosis?"

Zhou Can tried his best to save some face for Director Hong.
Chapter completed!