Chapter 1058: Chapter 1058: Is Hematuria the Main Symptom?
(Thanks to mmmwdl, Fusion, Naughty Dragon 1976, Desert Lone Wolf, Book Friend 080622184342591, Dragon King Village, songying_sy, Iron Asura, Little Fish 62 for the monthly ticket encouragement)
"Teacher Liu, the patient’s pain hasn’t improved. Should we give her a real analgesic?" Xu Yino hurriedly reported after checking.
"Go ahead, we’ll then head to eat. After eating, we’ll directly go to the ward and check on her again more thoroughly," Liu Banxia said.
From this point, we can also rule out psychological reasons for the pain. Phantom limb pain falls into the category of psychologically induced pain.
After the consultation, he had a general inclination. He felt that the pain was still caused by something within the patient’s abdomen, not due to nerve conduction issues.
He called everyone to the cafeteria, it’s worth adding some dishes. Everyone deserves to be happy about the record he set.
Many people in the Second Hospital felt amazed that, although the emergency center is very new, it has filled so many gaps in such a short time.
There have been innovations in surgical techniques, diagnostic methods, and other areas to a certain extent.
We must say the emergency center thinks boldly and acts boldly. The key is that they can do it clearly, which is remarkable.
Although they are new stars of the Second Hospital, they are definitely elites. Envy alone will not get you there. Influential doctors in the inpatient department naturally consider more issues.
And the young doctors? While they also want to create something refreshing, they don’t yet have that level of influence and strength.
When people study carefully, they find that most of the things the emergency center has brought forward have involved Liu Banxia.
Even though the fecal transplantation project seems unrelated to him, it was ultimately established because he persuaded everyone back and forth.
"Liu Yiqing, isn’t it just because you want to buy a house? Is it necessary to be this happy?" Liu Banxia asked.
"Teacher Liu, I’m not happy because I’m buying a house. I just like hearing people praise our emergency center," Liu Yiqing said with delight.
"Let’s not get too carried away, or it’ll affect our eating speed. If your mouth can’t close, how will you chew your food?" Liu Banxia said.
"Teacher Liu, what exactly is wrong with that patient? Does she really need to have a laparoscopic exploration?" Xu Yino asked.
"We’ll have a look after eating. If it really doesn’t work, we’ll have to go for a laparoscopic exploration," Liu Banxia said.
"I really don’t want to do it, but there’s no other way. In the current state of the patient, there’s no focal point, even an enhanced CT can’t be performed."
"Considering comprehensively, it seems that laparoscopic exploration is still the least invasive to the patient. You gave her painkillers, right? She didn’t say anything, right?"
"I explained to her clearly that the previous placebo was to see if it was psychologically induced pain." Xu Yino said.
"She understood very well and even expressed gratitude. Because in other hospitals, they don’t do it this way. They simply finish after an instrument check without going into such detail."
"Sigh... If it weren’t for seeing her current appearance and pained expression, I would have thought she was pretending," Liu Banxia sighed.
"I’ll have to thoroughly check her later. Patients with pain lead the most tormenting lives. Whether it’s abdominal pain or a headache, it’s very torturous."
"Our emergency center has received several similar cases, but those at least had some indicators. Although we might take a detour, we eventually find the source."
"This patient’s condition is too unusual, making it hard to categorize. The day after tomorrow, when promoting emergency knowledge, you and Liu Yiqing should come along, then just go to my place. It’ll save you from rushing from the hospital to the showroom."
"Received." The two girls responded with joy.
They were happy because they could have two more good meals.
"Then let’s speed up with eating, and we’ll head straight to that patient’s ward afterward," Liu Banxia added.
Hearing his words, everyone got busy. Even though it wasn’t easy eating with small chopsticks, they all tried hard to shove the food into their mouths.
Liu Banxia truly cared about this patient. Since she came for him, he felt obligated to do his utmost to help diagnose her condition.
It’s been a while since then, she was admitted yesterday. For two consecutive days, so many examinations were done, and it wasn’t easy. Money was spent, and the result is that nothing significant was found.
Even the urinary tract infection finding was of little help to the patient. Patient herself knew it too, saying she’s been regularly cleaning herself."
It’s due to physiological structure reasons, there will be always some issues here and there.
After finishing their meal, Liu Banxia led the group to the patient’s ward directly.
When they arrived, the patient was already peacefully asleep, snoring softly.
"Director Liu, this girl has really suffered. Only after taking that pain relief medicine did she finally calm down," the lady on the next bed said.
"Her condition is somewhat complex, so we need to continue with the examination." Liu Banxia nodded.
"Since she’s asleep, let her nap a little longer. Xu Yino, keep an eye on her, and call me when she wakes up. Then I’ll come over for further examination."
"Alright." Xu Yino replied.
"Teacher Liu, are you still worried about the patient?" Liu Yiqing asked.
"The more we fail to diagnose, the more I feel guilty. I tell you not to be influenced by the patient’s condition, but I’m working on it myself too. Did you notice anything from the recent observations?" Liu Banxia said.
"The patient is in too much pain from the symptoms. After taking painkillers, the relief makes her feel comfortable and relaxed, which is why she’s sleeping so soundly." Su Wenhao said.
Liu Banxia nodded, "That’s right. So our task is to help this patient find the source of her condition. We can’t end things so unclear."
Everyone nodded in agreement. Although they had seen many patients, they knew that symptoms like slowly being tortured by a dull knife were the most painful.
Because suffering from pain every moment, to put it unpleasantly, feels like late-stage cancer patients.
Late-stage cancer patients can receive palliative care and pain relief. She cannot, only getting limited medication, or severe consequences could occur.
Back in the office, Liu Banxia retrieved all examination documents to review them thoroughly for any overlooked data.
But after looking through everything, all was normal, except for the urinary tract infection that could be considered a symptom.
He then pulled out the latest urinalysis report.
An indication to note is the two plus signs for occult blood in the urine, which should be monitored. Even though it hasn’t reached three plus signs for visible hematuria, it’s still a symptom.
Results from the urinalysis showed non-glomerular origin for the erythrocyte morphology, indicating the hematuria comes from the urinary system below the glomeruli.
This is often seen in conditions like kidney stones, tumors, pyelonephritis, cystitis, tuberculosis, and acute or chronic urinary tract infections, currently matching with urinary tract infection.
Because both kidney function and morphology checks show the kidneys are healthy, but there’s inflammation in the urinary tract, which fits the scenario.
Is the hematuria related to the undiagnosed condition of the patient?
Liu Banxia pondered this question.
Because he recalled Huang Bo’s diagnosis a few days ago of a patient with fluid immune deficiency syndrome combined with PCP pneumonia, who also had a history of diarrhea. Both conditions can lead to diarrhea symptoms.
At the time, he discussed with Huang Bo the difficulty in distinguishing whether the diarrhea resulted from fluid immune deficiency syndrome, PCP pneumonia, or both jointly causing the symptoms.
Now, he finds it hard to define the hematuria. If it’s caused by urinary tract inflammation, that would be straightforward. It can be treated, observing whether hematuria persists.
But the downside is the time needed, meaning the patient suffers several more days.
During these days of waiting, the patient suffers pointlessly, spending money without any impact.
Nevertheless, Liu Banxia can’t provide a definitive judgment at the moment, so he’s considering consulting Wu Wenlin.
However, seeing no issues with the kidney-related examinations and that the patient’s abdominal pain is unlikely caused by urinary system inflammation, he decided against it.
The urology department is extremely busy, mainly because men of a certain age invariably experience some prostate-related issues.
"Why so downcast?" Shi Lei walked in.
"Ugh, I’m fretting over my patient. Right now, I have no clues. Can you take a look?" Liu Banxia said.
Shi Lei shook his head, "Su Wenhao also mentioned it to me, but I’m equally stumped. Wasn’t another digital exam scheduled? No results?"
"Haven’t gone yet; after taking the painkillers, the patient felt too comfortable and fell asleep. I can’t even imagine the level of pain the patient is enduring." Liu Banxia said.
"I’m really anxious now. So far, we’ve identified two symptoms: urinary tract infection and hematuria with two plus signs for occult blood. I can’t determine if the hematuria is due to the urinary tract infection, some other condition, or entirely unrelated."
"The patient’s mental state is poor and dietary intake is low, so even if other conditions are causing hematuria, it seems very possible."
"What about the kidneys?" Shi Lei asked with a frown.
"That’s precisely the problem—the kidneys haven’t shown any abnormalities, so I didn’t dare consult Teacher Wu, fearing I’d waste his time." Liu Banxia said, smiling wryly.
"I just believe the issue must still be within the abdomen, unrelated to nerves or psychological disorders. If the upcoming examination yields no results, I’ll consider laparoscopic exploration." Liu Banxia said.
Shi Lei nodded in agreement. Although laparoscopic exploration is invasive, there are limited options left.
