The patient's family is very rich. Before cirrhosis, he also visited many hospitals due to jaundice, but the diagnosis was gallstones and cholestasis.

Because there are no other symptoms except for a little yellow face, the patient doesn’t care for a while, but he turns into cirrhosis without realizing it.

In fact, the symptoms of the compensation period are also very mild, and a considerable number of people don’t feel anything.

When the decompensation period enters, the symptoms begin to go on stage, fatigue, weight loss, sharp appetite loss, and stubborn abdominal distension will appear one by one.

The patient also had a tertiary hospital before coming to Danyang Hospital.

Although they are all in the top three, there is still a gap in infrastructure and doctors' technical capabilities.

After 2000, minimally invasive doctors began to truly emerge. The junior high school kept up with the trend, actively introduced equipment, and constantly trained young backbone doctors to learn new technologies.

Some hospitals have only financial resources, but do not have the courage to constantly break through the existing balance. When they really need it, they will find that it is easy to buy equipment and spend some money, but talents need to be cultivated slowly.

This is the case with the hospital the patient went to.

A fiber duodenoscopy that was just imported a year ago was lying in the endoscopy room, but the doctors could only stare at it.

In fact, cholestasis caused by gallstones is rare because patients will have obvious jaundice and digestive tract symptoms. The cause of the liver being boiled into cirrhosis due to cholestasis is definitely not simple.

The surgeon was also very determined. After reading the B-ultrasound and CT reports, he diagnosed cholestatic cirrhosis.

Then there was a major abdominal surgery.

Now a T-tube is inserted into the patient's liver and gallbladder passage, and the upper part is blocked by stones. Because the condition is really not good and the liver function is very poor, it is too late to do ercp again.

Qi Jing held the examination report for viral hepatitis and muttered to himself: "No hepatitis B, no hepatitis C, no excessive drinking, just simple cholestasis..."

Looking at the differential diagnosis written by Hu Dongsheng one by one, Qi Jing left several special liver diseases in his mind.

"What caused cholestasis?" Qi Jing's question this time was very simple, so he did not ask the director at the meeting, but gave it to Hu Dongsheng.

"Gabuloss stones." Hu Dongsheng stopped writing without thinking.

"But the gallstone just blocked the T tube 12 hours after the operation, and it accumulated to the point of suppurative obstructive cholangitis in one night..." As he said that, Qi Jing looked at the directors, "Is the stagnation speed too fast?"

Obviously, this sentence successfully aroused the interest of all directors, especially Tong Miao, who specializes in liver and gallbladder, and Yu Tao, director of the gastroenterology department.

"What do you mean? Explain it."

At this time, Qi Jing finally picked up the marker and drew a simple liver and gallbladder pathway in the corner of the snow-white recording board: "I mean, the patient's cholestasis is different from ordinary siltation, and it is not just that stones block this path."

Yu Tao raised his index finger and tapped the coffee table table with his long nails. He asked while thinking: "Do you think something stimulates liver cells and increases the emission of bile?"

Qi Jing nodded.

“This idea is interesting.”

"We have indeed always focused our attention on sandbags blocking the river, forgetting the mountain torrents that broke out in the upstream." Yu Tao continued, "the factors that can promote bile emissions..."

"Inflammin."

"Bladder salt."

“Gastrophin.”

“High protein diet…”

"No, no, these things cannot cause such a severe bile emission, they must be other external factors."

Qi Jing flipped the medical record forward and found the examination picture on the B-ultrasound report as the basis for diagnosis. After careful reading, he handed the report to Li Zhiyong: "Teacher Li, is the intrahepatic bile duct fibrosis?"

"Well, there is indeed fibrosis, but this fibrosis is not specific." Li Zhiyong said.

After being affirmed by Li Zhiyong, the cause of the disease that Qi Jing had imagined in his heart finally had a reliable foothold. What we need to find now is direct evidence, which is submerged in a pile of blood and feces examination sheets.

The blood test surrounding this patient is blood routine, liver and kidney function and blood qi analysis.

Regarding the cause that Qi Jing now suspects, liver and kidney function and blood qi have no meaning. What he is looking for is the most common blood routine. In addition, he also needs a routine microscope for feces.

As he found a suspicious target, Qi Jing had completely given up the task of verbally reporting medical records and left Hu Dongsheng aside.

Since other copies of the medical record were placed in the general surgery ward, the directors sitting on the sofa had nothing to do, so they could only watch him flip through the medical record

The patient's blood routine has been performed five times since he was admitted to the hospital.

Among these same report lists, there is indeed a data-out order.

In the complicated blood cell project column, there were countless arrows up and down, but he picked a cell item that was usually very inconspicuous: "Director Tong, the patient's blood on June 10th is a bit high."

Tong Miao nodded: "The patient has a bit of asthma, and it is normal for the patient to have higher eosinophilia. Besides, only one of the five blood routines indicates that the eosinophilia is high, and the value is not much, so it dropped again the next day."

"This doesn't mean anything."

"No, this will definitely explain something." Qi Jing turned the medical record to the surgical record again, "This test test was done the next day after the operation."

As he got closer and closer to his mind's answer, Qi Jing's attitude also changed a little. He seemed to have returned to the era when he was on par with the directors, and he had no scruples in his words.

The directors like active-thinking students very much, but they don’t like being offended.

"Okay, hurry up and finish writing the medical records on the record board." Tong Miao looked at the watch, obviously feeling a little unhappy, "We will continue to discuss after it is finished."

Just because he knocked on the door, Qi Jing took nearly half an hour for the ten directors. Although the child’s views were new and interesting, this condescending look made people feel uncomfortable.

But at this moment, Cai Ping, director of the infectious disease department in the distance, stood up, her eyes full of the glory of maternal love for cherishing and loving talents.

Inspired by Qi Jing, her idea of ​​being restricted by several internal and surgical directors just now seemed to be opened: "Come on, good boy, keep talking, they won't listen to me."

"Director Cai, we have only half discussed here..." Tong Miao seemed very embarrassed.

"Old boy, why are you anxious? Let me finish asking questions before talking." Cai Ping obviously became very interested in Qi Jing and had no room for bargaining.

"Okay OK."

Qi Jing sent the test form to the director of the University of Infectious Diseases: "Director Cai, I think his eosinophil eosinophil eruption has nothing to do with asthma."

Cai Ping nodded, as if she knew what Qi Jing was looking for: "Transparent elevation can indeed be regarded as a reminder, but the patient's fecal microscopy is good."

She turned two pages back and took out a negative fecal test form.

"Feed tests are based on luck, and false negatives are normal."

Seeing that Qi Jing was talking very well, Cai Ping liked the more she heard her. The smile on her face even covered up a lot of wrinkles, making her look several years younger.

There are only a few talents in the infectious department, and she hasn't taught graduate students for a long time. She can't be moved by such a good seedling in front of her.

"The blood and fecal examinations are not good, so tell me how to diagnose it now?"

"You can try continuous T-tube lavage."

"How sure are you?"

Qi Jing smiled: "There has been changes in the b-ultrasound, and the abnormal eosinophils, and the gallstones caused by gallstones and huge amounts of gallstones. The patient's illness is still so long... I think 99% of it is that thing."

"Not bad!"

Cai Ping smiled and praised Qi Jing, then said to the other directors: "This patient is under the infectious disease department, so you can sit on the sofa and drink tea and chat with peace of mind."
Chapter completed!