Chapter 332 Emergency Room 3: Is he dead? Is he saved?

Xu Qiu stared at Tao Changhan's face.

His lips still had the cyanosis of hypoxia, but they were cracked due to dryness, split into petals, like the torn earth.

He touched the skin with his hand.

The patient's skin was also dry and white, and the finger joints were too dry, so the slightest movement could tear open wounds.

In the two days before discharge, the patient had stopped the infusion, and his diet and nutrition were getting closer to those of a healthy person.

Therefore, the patient had to make up for the water himself.

Xu Qiu asked: "How much water did he drink in the past two days?"

Tao: "Not a few sips."

"What about eating?"

"He has no appetite and eats very little."

With this question and answer, Xu Qiu had the answer in his mind.

Judging from Tao Changhan's physical condition, his daily water intake may be just enough to sustain his life.

If he drinks less, even if he has diabetes insipidus, his urine volume will not be exaggerated.

In other words, if Tao Changhan had no complications at this time, based on his water intake, his daily urine output might be very small!

Even close to oliguria or anuria.

But his urine output still reached 2800 ml!

This is already a very scary number for a patient who does not drink water.

"Contact the imaging department, do a head CT, focus on the examination!" Xu Qiu made a prompt decision and gave further medical advice.

...

While the patient was being transferred, Xu Qiu returned to the office.

There were piles of literature on the desk, which were all collected by him, and they were intracranial tumors that could cause repeated fever, mutism and other manifestations.

Mutism is mostly caused by damage to the brainstem or thalamic reticular ascending activation system. It is more common in frontal lobe tumors clinically, followed by temporal lobe tumors.

Although neuroepithelial tumors, such as gliomas, can also cause mutism, its most characteristic manifestation is dull repetition, etc., and there are also depressive symptoms such as insomnia or early awakening, which do not match Tao Changhan's performance.

And larger tumors were also ruled out by Xu Qiu.

The patient did not show signs of increased intracranial pressure, nor did he show mental disorders such as drowsiness, stupor, coma, etc. In addition, the tumor indicators were not high, so it was unlikely that it was a large tumor.

It was most likely a small tumor.

This is why Xu Qiu asked the imaging department to focus on the examination - if it was just an ordinary patient, the doctor would inevitably miss some information.

"It's not this..."

"It's not a tumor in the sella turcica either."

A few hours later, Xu Qiu searched the literature for a long time, but still did not get a satisfactory answer.

At this time, the imaging department also gave a report.

"No obvious abnormalities were found."

It was followed by a sentence "This report is for clinical reference only, no final diagnosis, further examination is recommended."

This is the culmination of the three links of the hospital.

Medical students' three links, "I don't know", "I'm a student", "Ask the doctor".

Endocrinology three links. "What did you eat in the morning", "What did you eat at noon", "What did you eat at night".

The imaging department said "The nature is to be determined", "Further examination is recommended", "Please combine with clinical practice".

The three links in the emergency department were even more sturdy, and they were "Is he dead?" "Is he alive?" "Please consult a specialist."

...

"Sure enough, I can't find it."

Xu Qiu shook his head. This was expected.

He called up the patient's CT film and examined it carefully.

However, there was no abnormality.

Xu Qiu took a look and saw that the diagnosis was made by Director Zhang Hao of the Imaging Department. The other party was the director of the Linhai Medical Imaging Teaching and Research Section. He was very capable and could make the judgment that there was no obvious abnormality. Naturally, it was not something that other people could find out after just a few minutes of casual observation.

If this film was from another patient, it would have been determined that there was no problem.

However, relying on naproxen, as well as the unique neurological pathological manifestations such as mutism, diabetes insipidus, and binocular movement disorders, Xu Qiu could also confirm that Tao Changhan definitely had a tumor in his brain.

What the doctor had to do now was not to prove its existence.

But to find where it was and the pathological type of the tumor.

Before Xu Qiu could continue to think deeply, Director Zhang Hao of the Imaging Department called.

"Doctor Xu, have you read the report?"

Xu Qiu: "Yes."

"The patient you mentioned has very low tumor indicators, but since the naproxen experiment has proven effective, there should be a tumor. My suggestion is to try an MRI."

The disadvantage of CT is that it can only scan layer by layer.

If the tumor is too small, and the CT set scanning layer spacing is 10mm, and the tumor happens to be in the area skipped by 10mm, then it will naturally not be found.

Even with thin-layer scanning, 2~3mm layer spacing, it is inevitable that omissions or difficulties in detection will occur.

MR does not have this limitation.

It can observe the situation at any position at any angle and any direction, without any blind spots, and has more advantages in detecting hidden tumors.

"Okay, let's do an MRI further." Xu Qiu also agreed with this proposal.

Zhang Hao added: "In this way, I will communicate with the patient's family and upload the images to the forum to see if other colleagues can see anything or make some constructive suggestions."

"Yes."

Xu Qiu's attention was not on this CT film that did not have much meaning.

After hanging up the phone, he plunged into the documents again, trying to find some information.

On the other side, Zhang Hao put down his phone and talked to Tao Changhan, Tao and others, and obtained their consent. He finally uploaded the CT report to the medical imaging forum, and also in the group chats of "Baiyun Province Imaging Pioneer" and "Daxia Radiologist".

As for Linhai City...

He is the director of the teaching and research section of the Linhai City Imaging Department. If even he can't handle it, let alone others.

Soon, this image caused a discussion.

"Isn't this a normal person's CT?"

"I didn't see any performance..."

"I took a look and the person who posted the certification was Director Zhang Hao of Linhai First Hospital. This is Linhai First Hospital where Xu Qiu was born!"

Everyone immediately became serious.

After a serious analysis, they came to a rigorous conclusion: there is indeed no abnormality...

At this time, Zhang Hao's WeChat group was also refreshing the screen.

Director Zhou of the Imaging Department of Jinghai People's Hospital: "I don't understand why Dr. Xu's patients were withdrawn after one look."

Director of Jing'an Cancer Hospital: " @Han Jinxing, @Wei An."

Han Jinxing and Wei An are respectively the deputy directors of the Cancer Hospital of Daxia Academy of Medical Sciences and the deputy directors of the Cancer Hospital Affiliated to Sun Yat-sen University.

The former is the leader of cancer hospitals, affiliated to the Union Medical College, with extremely strong resources and strength, and no one can match it.

The latter is a rising star, the undisputed first cancer hospital in the south, backed by the Sun Yat-sen College, and has written the clinical guidelines for nasopharynx and throat on its own, with great potential to take the top spot in the industry within ten years.