latelenovela Chapter 548
Chapter 548
The patient Huang Chen, who has long-term diarrhea, has a high possibility of pancreatic cancer.
Because the patient has a history of pancreatitis, the possibility of re-injury of the pancreas is quite large.
And
Just when he was complaining, the patient Huang Chen said that he had lost nearly 10 pounds in more than half a month.
The symptoms of pancreatic cancer are varied, the most common are abdominal pain, weight loss, jaundice (pancreatic head cancer is the most common, almost 90% have jaundice).
In addition, there is poor appetite, indigestion, diarrhea and so on...
As a result, patients with pancreatic cancer become thinner.
"Do you usually smoke, drink, or drink coffee?"
"I don't smoke or drink, but I like to drink coffee, and I drink two or three cups almost every morning and evening..."
“.................."
"Doctor, can't you drink coffee?"
"Neither will coffee... Long-term heavy smoking, drinking, coffee, etc. are all high-risk factors for pancreatic cancer..."
“.................."
The patient Huang Chen was already a little desperate in his heart.
Is it really pancreatic cancer?
If you already know it, you won't drink coffee.
Lin Feng comforted: "Don't get discouraged so quickly, it may not be pancreatic cancer... Go for a Ct and you'll see the results..."
Patient Huang Chen was flustered: "Okay, okay..."
Lin Feng continued to return to the consultation room to diagnose the patient.
......
In the afternoon,
The rheumatology immunoassay project of patient Huang Chen was sent to the laboratory department.
In addition, Huang Chen also lined up to go for CT.
Lucky!
· CT results showed that no obvious abnormalities were seen in the hepatobiliary, pancreatic, and spleen. The pancreas, in particular, did not see any manifestations of pancreatic cancer.
Also, the size of the pancreas seen by CT is normal, with no signs of pancreatitis.
Therefore, long-term diarrhea due to pancreatic problems is excluded.
What would be the reason for that?
Rheumatic immunity?
After waiting another 2 hours, the simple rheumatic immunization results also came out.
Rheumatic immunity four items: negative results.
Gastroenteritis, bowel cancer, liver and kidney, pancreas, heart were excluded... and other possible reasons.
So what's left?
Now,
It has returned to its original stage.
"Thyroid?"
Lin Feng subconsciously thought to the thyroid gland.
Because the liver, gallbladder, spleen, pancreas, heart and intestines are excluded, only the thyroid, brain and other organs remain.
Lin Feng has thought about thyroid - hyperthyroidism!
hyperthyroidism
In fact, it can also cause diarrhea.
But why didn't Lin Feng consider hyperthyroidism at the beginning?
Because the patient does not have manifestations of hyperthyroidism: exophthalmos + no tremor in the hands.
And the neck gets a little bigger...
But
Now everything is ruled out, only hyperthyroidism remains.
Lin Feng came to the hospital bed again and asked the patient Huang Chen.
"Do you have any easy agitation, irritability, insomnia, palpitations, and heat intolerance?"
"No, I feel like I'm fine..."
"Is there an easy sweat..."
"Nor ..."
In addition, hyperthyroidism will also have increased appetite, but the patient Huang Chen said that his appetite has not been good recently, so it is not right.
What Lin Feng asked above are typical symptoms of hyperthyroidism.
But
Now the patient Huang Chen denies it one by one, but there are none.
The only symptom is: diarrhea!!
But
Lin Feng considered that this patient Huang Chen may be "apathetic hyperthyroidism".
This is a relatively rare type.
Manifestations are fatigue, palpitations, poor appetite, diarrhea, etc.
At first, Lin Feng didn't think about this side.
The possibilities are not very great.
But now, after excluding so much, you can check whether it is "apathetic hyperthyroidism".
"Xiao Chen, draw blood for him and do a jia gong..."
"Okay."
Lin Feng gave medical advice, and then left the ward.
......
The next day, morning,
Jia gong is out!
・Thyroxine index increased by 3 times!!
OK: Hyperthyroidism!!
When Lin Feng saw this result, he was weird!
The murderer was found.
It turned out to be really "apathetic hyperthyroidism".
Apathetic hyperthyroidism, also known as covert hyperthyroidism, is a special type of hyperthyroidism.
It mostly occurs in the elderly, and occasionally in middle-aged people, but the patient in front of him, Huang Chen, is obviously a young man, only in his 20s.
This disease, the symptoms are extremely atypical, easy to misdiagnose and miss.
It manifests as long-term chronic diarrhea without abdominal pain, accompanied by loss of appetite, weight loss, and fatigue. There are no hypermetabolic symptoms such as heat intolerance, hyperphagia, and heavy sweating.
And
In general, the heart rate of patients with hyperthyroidism is increased, but apathetic hyperthyroidism does not increase, rarely exceeding 100 beats per minute.
PS: When patient Huang Chen was admitted to the hospital, his heart rate exceeded 100, which may be due to increased heart rate caused by hypovolemic shock.
So
The final diagnosis: "apathetic hyperthyroidism"!
Lin Feng immediately prescribed the corresponding drug to the patient, "propylthiouracil (hynilb)", which blocks thyroid hormone synthesis by inhibiting the peroxidase system in the thyroid gland.
After taking,
It only took half a day, and the patient Huang Chen's condition improved significantly.
Diarrhea stops!
"Doctor Lin, you are so powerful!!"
Huang Chen, a patient who finally didn't have to have diarrhea, was about to fall tears at this moment.
Took Lin Feng's hand and thanked him again and again.
......
Summary: Apathetic hyperthyroidism, contrary to ordinary hyperthyroidism, can cause prolonged diarrhea.
......
......
Just when Lin Feng was eating at noon and hadn't returned to the consultation room...
"Bell Bell ~~~~~"
The phone rings.
Father's WeChat video.
"Son..."
"Mom, what's wrong?"
Lin Feng smiled.
Father: "Son, when the third uncle was just doing farm work, his ears seemed to have entered the worm, the ear was old and painful, the bug kept drilling and drilling inside, at first he dug the ear spoon to dig, but the result could not be dug out, as if the bug went even more into it... Now I don't know what to do, you hurry up and think of a way for your third uncle..."
Ears into bugs?
Lin Feng was shocked.
That's no small thing.
If you run to the eardrum and get through the fragile eardrum, it will be troublesome.
At this time, the third aunt snatched the phone: "Ah Feng, you must save your third uncle, what if he is deaf..."
The voice was crying.
Lin Feng: "Third aunt, don't worry... I said, you guys do it, get rid of the bugs as soon as possible..."
.