Chapter 2069： Telescopic stones

Zhou Zong, the patient's left side of the waist pain, urine routine white blood cells, red blood cells + + +, standing abdominal plain film can see high density shadow near the left side of the 2-3 lumbar vertebrae. "The doctor on duty is tired and instinctively reports the medical history: "The patient does not agree to hospitalization, and he is given antispasmodic and analgesic treatment. ”

"Is it not good?" Zhou Litao asked.

"Generally, the pain of private prosecution has eased, but I think it should still be painful. I persuaded twice and said that I would not be hospitalized."

"How is the physical examination?"

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

The film is inserted into the reader, and a high-density shadow of about 1.5 cm in diameter near the left side of the 2-3 lumbar vertebra is so conspicuous.

Under normal circumstances, the abdominal perforation and abdominal plain film are the commonly used means for diagnosing urinary calculi.

The situation of this patient is very typical, but Zhou Litao looked at the film, but he remembered what he had just said on duty doctor.

The slap pain on the left side is obvious, this is what it should be.

However, there is also a slap in the right waist. It is possible to conduct the past. But Zhou Litao still felt that something was wrong, and turned his attention to the film on the reader.

He carefully looked at the flat abdomen and the ureter did not see stones. As for the following, the part close to the kidney is not visible to the X-ray film.

A check to determine the left ureteral calculi, according to the normal medical procedures, should not be done other tests.

Otherwise, someone will be detained with a big hat of over-medication.

Just like this, it is estimated that it is cold and the ureter is paralyzed, which causes the pain to be relieved. Zhou Litao took the film down and put it into the pocket, but the whole process was a little hesitant.

His mind is still thinking about the positive signs of physical examination.

Early in the morning, belonging to the most leisure time in the emergency department, Zhou Litao took the film to the rescue room and began to ask about his medical history.

The patient and the family of the patient tell the story of the condition.

Nothing worth noting is that I slept early last night and opened the window. As a result, the temperature dropped in the middle of the night, and the left side of the waist and abdomen began to hurt.

At the beginning, I thought it was cold. I closed the window and went to the bathroom.

I didn't expect the pain to get worse and worse, almost fainting on the toilet. The patient called the family and sent him to the emergency department of 912.

Urinary calculi, said that the weight is not heavy, said light and light disease. Although the patient had a great pain, but he had a friend who had had extracorporeal debris, he described the process of extracorporeal lithotripsy.

The strong fear made him refuse to hesitate to treat the extracorporeal lithotripsy and other treatments without hesitation. He only stayed in the emergency department for symptomatic treatment and observed changes in the condition.

In fact, it is also that when others say that they are sick, they are all heads. This is a type of standing and not hurting, after all, many things can not feel the same.

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

Zhou Litao carefully examined the patient.

His left hand is pressed against the patient's left waist and the right hand is gently tapped on the back of his left hand.

"It hurts." The patient frowned and rubbed his teeth, and said a painful face.

Zhou Litao then changed the patient's position and began to make a sniper on the right side of the waist.

The right hand tapped on the back of the left hand. I didn't expect the patient to scream, and the body began to tremble a few times, and the bow was even more powerful.

"Doctor, light, light." The patient's lover looked at his heart and almost cried.

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

"The left side hurts." The patient's voice has changed because of pain.

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

"The whole stomach hurts, can't stand it... Doctor, don't knock me, knock it once." The patient said with a sad face.

His face was a bit white and pale, and Zhou Litao estimated that it was caused by pain. It doesn't look like it's loaded, and the transmitted pain doesn't seem to be so heavy.

Strange, the sense of autonomy is pain on the left side, and the X-ray film of the standing position also proves this. However, when checking the body, it gave Zhou Litao an illusion that the patient had a problem with the right urinary system.

This kind of physical examination is not very common with the symptoms of private prosecution and clinical examination.

Zhou Litao covered the patient's clothes and asked about a series of situations such as family history and past history, which was full of doubts.

There are no notable problems. Zhou Litao still wants to check it again to see if he has not noticed it. The patient almost cried and asked him not to check his body.

Since the last time she encountered a girl with abdominal epilepsy for 16 years, Zhou Litao has listed the family history as a project that must be asked.

Clinical diagnosis and treatment are just a little bit of growth through experience accumulation.

The patient's family history, past history is no problem, there is a family history of hypertension, but he does not have high blood pressure.

Zhou Litao tried hard to figure out, and soon made up his mind to communicate with the patients and the family members of the patients, and prepare to make a B-ultrasound and then confirm.

The family members of the patient agreed, after all, the pain was slightly relieved after the medication, but it was not very obvious.

In addition, in the choice of spending money and physical examination, the patient almost did not hesitate to choose to spend money to do the same check.

Logically speaking, as long as the stone is stuck in the ureter, the pain will not change much. www.novelhall.com~ Also drink plenty of water, exercise vigorously, let the stone fall out.

The pain is a bit weird, and Zhou Litao’s doubts have not been explained.

The wheelchair pushed the patient to check. He twisted his body in a wheelchair and was weak. It seemed that only half of his life was left.

Zhou Litao is used to such patients, and he is not very empathetic. What he pondered in his mind was the inconsistency between physical examination and symptoms and imaging data.

What is the strange problem?

If you can't do it, you will pull down the urology department and discuss it. Zhou Litao decided to make a big fuss. Even if you are always unhappy, you must make a clear diagnosis.

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

The family members of the patient are somewhat confused and even unhappy.

"I have a look at the report." Zhou Litao went to the list.

"Doctor, how does the B-ultrasound have a problem on the right side? Is it wrong?" asked the patient's family.

Zhou Litao’s heart jumped a bit.

Right? That is in line with the examination. But X-ray film and patient self-reported symptoms...

He immediately watched the B-ultrasound report.

Right kidney water, right kidney near the proximal ureter, found a 2cm stone. The left kidney and the ureter have no problem at all.

MD! Zhou Litao’s hand with the report form began to tremble.

It is said that there is a problem, but the clinical examinations are against each other. What is the reason?

No problem on the left side? The high-density shadow on the left side of the 2-3 lumbar vertebrae, looking at the image of the stone is what it is!

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