Chapter 2068 The Stone that Can Teleport (Leader Mouse 09 Plus 1)

"Mr. Zhou, the patient has pain in the left side of the waist. There are white blood cells and red blood cells +++ in the urine test. The upright abdominal plain film shows high-density shadows near the left 2-3 lumbar vertebrae." The doctor on duty looked tired and reported the medical history instinctively. : "The patient does not agree to be hospitalized, and antispasmodic and analgesic treatments are given."

"The effect is not good?" Zhou Litao asked.

"Generally speaking, the self-reported pain has been relieved, but I think it should still be in pain. After persuasion twice, I refused to be hospitalized for stone crushing."

"How about the physical examination?"

"The pain on the left side of the waist is obvious, and the right side is also quite obvious." The doctor on duty went to the emergency room and showed Zhou Litao the patient's standing X-ray.

The film was inserted into the film reader, and a high-density shadow with a diameter of about 1.5 cm near the left 2-3 lumbar vertebrae was so conspicuous.

In general, upright peritoneal dialysis and plain abdominal radiographs are commonly used methods for diagnosing urinary calculi.

This patient's condition is very typical, but Zhou Litao watched the film, but recalled what the doctor on duty just said in his mind.

Percussion pain on the left side is obvious, which is what it should be.

But there is also percussion pain in the right waist, and it is possible that it is passed on. But Zhou Litao still felt that something was wrong, so he turned his attention to the film on the film reader.

He carefully looked at the upright abdominal plain film, no stones were found in the right ureter. As for the lower part, near the kidney, it cannot be seen clearly by X-rays.

A test confirmed that it was a left ureteral calculus. According to the normal diagnosis and treatment procedures, no other tests should be done.

Otherwise, who would be able to bear the label of excessive medical treatment?

That's it, it's probably because of the cold weather and the spasm of the ureter, which caused the pain to be unrelieved. Zhou Litao took off the film and put it into the film bag, but he hesitated a little during the whole process.

He was still thinking about the positive signs of the physical examination.

Early in the morning, the most leisure time in the emergency department, Zhou Litao came to the emergency room with the film in hand, and began to ask about the medical history by himself.

The patient and the family members of the patient described the course of the disease.

Nothing worth noting, just went to bed early last night with the windows open. As a result, the temperature dropped in the middle of the night, and the left waist and abdomen began to hurt.

At first, I thought I was catching a cold, so I got up and closed the window, and went to the bathroom.

Unexpectedly, the pain got worse and worse, and I almost fainted on the toilet. The patient woke up his family and sent him to the emergency department of 912.

Urinary stones, whether it is serious or not, is a disease that is not serious. Although the patient was in severe pain, he had a friend who had undergone extracorporeal lithotripsy and described to him the process of extracorporeal lithotripsy.

The strong sense of fear made him refuse the extracorporeal lithotripsy and other treatments without hesitation, and he only stayed in the emergency department for symptomatic treatment and observed changes in his condition.

In fact, it is also true. When others talk about diseases, they all speak clearly and clearly. These are all types of standing and talking without back pain. After all, many things cannot be empathized.

Fear is a normal emotion, just don't affect the normal diagnosis and treatment.

Zhou Litao carefully examined the patient.

His left hand pressed on the patient's left waist, and his right hand lightly tapped on the back of his left hand.

"It hurts." The patient frowned, gritted his teeth, and said in pain.

Zhou Litao then asked the patient to change his position and began to perform percussion on the right waist.

The right hand tapped lightly on the back of the left hand. Unexpectedly, the patient yelled, his body began to tremble a few times, and the bow became even stronger.

"Doctor, take it easy, take it easy." The patient's lover felt his heart ache when he saw it, and almost cried.

"Do you have pain on the left side or the right side?" Zhou Litao asked suspiciously.

"It hurts on the left side." The patient's voice had changed due to the pain.

"Then I knocked on your right side, how do you feel?"

"The whole stomach hurts, I can't bear it...Doctor, don't hit me, it will kill me once." The patient said with a sad face.

His face was a little pale, pale, Zhou Litao guessed it was caused by the pain. It doesn't look like it's an act, and the transmitted pain doesn't seem to be so severe.

Strangely, the autonomic sensation was pain on the left side, and the X-ray film in the upright position also proved this point. But during the physical examination, Zhou Litao was given the illusion that the patient had a problem with the right urinary system.

This discrepancy between physical examination and self-reported symptoms and clinical examination is not very common.

Zhou Litao covered the patient's clothes, asked about family history, past history, etc., and then left full of suspicion.

There was nothing worth noting. Zhou Litao wanted to check again to see if he hadn't noticed anything. The patient almost cried and begged him not to do the physical examination.

Since the last time he met a girl with abdominal epilepsy 16 years ago, Zhou Litao has listed the family history as a must-ask item.

Clinical diagnosis and treatment, this is how to accumulate experience and grow little by little.

The patient's family history and past history are fine, and he has a family history of hypertension, but he does not have hypertension.

Zhou Litao pondered hard, and quickly made up his mind, communicated with the patient and the patient's family, and prepared to do a B-ultrasound to confirm.

The patient's family members agreed. After all, the pain was slightly relieved after taking the medicine, but it was not obvious.

Besides, when choosing between the two options of spending money and having a physical examination, the patient almost without hesitation chooses to spend money for another examination.

Logically speaking, as long as the stone is stuck in the ureter, the pain will not change much. You need to drink a lot of water and exercise vigorously to let the stone fall out.

The pain was a bit weird, and Zhou Litao's doubts in his heart had not been explained.

The wheelchair pushed the patient for an examination. He twisted his body in the wheelchair, weak, as if he had only half his life left.

Zhou Litao is used to seeing this kind of patients, so he doesn't quite empathize with them. All he thought about was the inconsistency between the physical examination and the symptoms and imaging data.

What kind of strange problem?

If it doesn't work, let Mr. Yu from the Department of Urology come down for a consultation. Zhou Litao decided to make a fuss over a molehill. Even if Mr. Yu is unhappy, he must make a clear diagnosis.

Soon, the patient came back with a report card in his hand.

The family members of the patients were a little confused and even a little unhappy.

"Let me take a look at the report." Zhou Litao stepped forward and asked for the report.

"Doctor, what does the B-ultrasound mean that there is a problem on the right side? Is it a mistake?" asked the patient's family.

Zhou Litao's heart skipped a beat.

Is it on the right side? That's in line with the physical examination. But X-ray plain films and patients' self-reported symptoms...

He immediately read the B-ultrasound report.

Right hydronephrosis, the right kidney was near the proximal end of the ureter, and a stone of about 2cm was found. But the left kidney and ureter, but there is no problem at all.

MD! Zhou Litao's hand holding the report began to tremble a little.

It is said that there is a problem, but the clinical examinations contradict each other, what is the reason for this?

Is the left side okay? What is the high-density image next to the left 2-3 lumbar vertebrae, which looks like a stone!