NOVPUBChapter 338 -165 Found the Cause, Difficult to Medicate
Dr. Chi initially didn’t pay much attention because Zhou Can was just a resident in training.
He thought that one of the doctors from the Intensive Care Medicine Department had sent Zhou Can to learn about the patient’s diagnostic and treatment situation.
“During the examination of the patient, intestinal bleeding was discovered. Can you describe the details?”
“At that time, angiography was performed on the patient, and the bleeding was mainly concentrated in the colon section of the large intestine. It was multiple and diffuse bleeding,” Dr. Xia Ping introduced the situation at the time.
He is the attending physician and also the chief treating doctor, who knows the patient’s condition best.
Diffuse bleeding is most dangerous when it occurs inside the skull.
It spreads like smoke, indicating simultaneous bleeding at multiple sites, often seen with chronic bleeding. This type of bleeding is often related to superficial capillary lesions or dilatation. Sepsis is also a common cause.
“What about other sections of the intestine? Were there any signs of bleeding?”
Zhou Can continued to inquire.
This phone call was hugely rewarding.
At the very least, he had preliminarily inquired about the information he wanted to know.
“There was almost no bleeding in the cecum, and there were slight signs of bleeding in the rectum. No bleeding was found in the anal canal either. Subsequently, at the persistent pleading of the family, I took a risk and treated the patient with a colonoscopy. Consistent with the results of the angiography, the main bleeding was concentrated in the colon. There was also a small amount of bleeding in the rectum. Treatments using thrombin, cryotherapy, none were effective.”
“Through observation and comparison, I also found that the bleeding points seen during endoscopy were different from those found during angiography. I’m certain that the bleeding sites in the patient were changing continuously.”
Dr. Xia narrated all his findings.
After hearing this, Zhou Can became even more certain that the problem was with the small intestine.
The detailed information obtained from Xia Ping was invaluable.
“Do you think there’s a possibility that malignant tumors have infiltrated the intestinal wall, causing bleeding?”
Zhou Can was doing the final elimination.
If malignant tumors could be ruled out, then he could narrow down the diagnostic range even further.
“It’s very unlikely that it’s a malignant tumor. At least colorectal cancer can essentially be ruled out.”
Dr. Xia spoke rather conservatively.
This was a rhetorical skill honed by experienced doctors through being tested in various tough situations.
Only very capable doctors, confident within their own area of expertise, dare to speak with certainty.
Otherwise, it was a tactical play of words that could advance or retreat.
“Dr. Zhou, may I ask who your supervising doctor is? Did they send you to inquire about the patient’s condition?” Dr. Xia seemed to catch on to something amiss and started to question Zhou Can instead.
“My supervising doctor is Doctor Hu Yiba from the Intensive Care Medicine Department. Doctor Hu is not aware of this, it was on my own initiative to understand the patient’s condition that I took the liberty of bothering you.”
Zhou Can didn’t dare to speak carelessly.
Many doctors in the hospital knew each other, and it wouldn’t take much to find out the truth.
He definitely didn’t want to be labeled as dishonest.
“I see! I’m actually quite busy here, so if there’s nothing else, let’s leave it at that!” Dr. Xia’s attitude cooled off a lot as soon as he heard it was Zhou Can’s idea.
Supervising doctors often deal with rookies like Zhou Can, who pepper them with various questions like curious babies.
Supervising doctors might have a bit more patience for their own trainees that they are responsible for teaching. For unrelated junior doctors, the attitude is generally dismissive.
“Could you elaborate on the specific treatments you have administered to the patient?”
Zhou Can wanted to understand even more details.
Especially the treatment methods used by the attending doctor, the effects after treatment, and the patient’s reactions.
These data were extremely valuable and could help him better diagnose the patient’s condition.
Why is the diagnosis of some complex and puzzling diseases difficult?
Because all the common causes have been ruled out one by one. It requires the attending physician to personally try, like a horse crossing a river, to find a path nobody had taken before.
“What specific treatments have been done, you can directly look up the medical records. I have something to attend to now, goodbye.”
With that said, without waiting for Zhou Can to say anything more.
The phone was immediately hung up on the other side, and a busy tone signaled the end of the call.
This Dr. Xia was quite pragmatic.
Zhou Can was speechless.
Luckily, he had already obtained a lot of key information, and the call had been fruitful.
“New doctors should be eager to learn, and it’s a good thing, but you have to be moderate. We attending physicians are usually very busy, and there aren’t many willing to spend their personal time answering all sorts of miscellaneous questions.”
Dr. Chi’s words to Zhou Can were more of a warning.
There was no malice.
Just telling Zhou Can not to be so brash next time, casually bothering a superior doctor was a very disliked action.
Zhou Can didn’t argue.
Instead, he thanked him and quickly left.
By now, he had almost pinpointed the patient’s lesion to be in the small intestine.
As for the specific cause, after eliminating possibilities one by one, a sudden inspiration flashed in his mind.
Could it be parasites? Moreover, this parasite wasn’t in the large intestine but hiding in the small intestine.
[Pathological Diagnosis Experience Points +1.]
Experience Points had been rewarded, which indicated his diagnosis was correct.
To make a final confirmation, further examination of the patient would be needed.
Zhou Can was excited.
Persistence pays off; the diagnosis of this patient had finally taken a significant step forward.
At this moment, the cause of the disease was basically clear.
The patient’s small intestine was afflicted by a parasite.
