Chapter 289 The results are out
"Let me take a look at the case."
"Okay, here you go, Doctor Wei!"
The attending physician sent the case.
Wei Ping took the case and took a look.
Tuberculosis of the cervical lymph nodes, and it is not typical tuberculosis. Mycobacterium tuberculosis can also cause repeated inflammation, but it is generally not so obvious redness, swelling, heat and pain.
In addition, the patient did not have obvious symptoms of tuberculosis such as cough, sputum, chest pain, and hemoptysis.
Finally, he looked at the chest CT scan, which showed that the chest was clean and no lesions were found.
Neutrophils were significantly elevated.
Neutrophils specifically target common bacteria. Therefore, it must be a pathogen. But if it were, antibiotics would have been effective.
He looked at the case and some people suspected it was HIV because the redness, swelling, heat and pain in the neck, swollen lymph nodes and fever might be HIV or something like that.
But the result is not.
In the end, the inflammation was treated as caused by bacteria.
Ceftriaxone + azithromycin are used at the same time.
However, the patient did not experience any relief.
He also went around in circles and finally returned to dermatology.
And the patient requested that Wei Ping participate in the consultation.
Because Wei Ping’s number is not available.
Even if you go to see it, they may not be free.
In order to find out the cause of the disease, Pang Zhong put on a stern face and went to find Wei Ping.
Everyone was talking at once.
Finally, Wei Ping walked to the patient's side.
The perspective began.
Looking closely at the patient's redness and swelling, there was an early inflammatory reaction, which was bacterial.
However, in theory, antibiotics can basically cure the disease.
Why is it getting worse?
Wei Ping didn't understand.
Until I remembered a rare disease I had read about before, which was a congenital disease of the neck, a disease that most people would not think of.
"I suspect it's a pyriform sinus fistula!"
Wei Ping finally made a diagnosis.
At this time, the APP prompts.
"Congratulations on diagnosing a pyriform sinus fistula. You'll receive RMB 3,000! Proficiency +300, /"
Condition analysis: Pyriform sinus fistula is relatively rare in clinical practice and is divided into congenital and acquired secondary types based on the pathogenic factors.
Congenital pyriform sinus fistulas can cause suppurative infections in the neck, which can be easily misdiagnosed as suppurative thyroiditis. Currently, the most established treatment involves direct laryngoscope access and heat treatment with lasers, electrocautery, or low-temperature plasma to promote adhesion closure of the fistula opening.
Acquired pyriform sinus fistulas are mainly caused by trauma, surgery, foreign bodies, or gastroscopy. Usually, a nasogastric tube is inserted for feeding and conservative treatment for about two weeks is used. If this is ineffective, surgical repair via an external cervical approach is required.
Sure enough, that's it.
But his words made everyone confused.
Because the disease is so rare.
And one of the attending doctors directly looked up the encyclopedia.
He said, "There's a small recess near our throat, shaped like the concave head of a pear, or a dimple, hence the name. There's one on each side. If the embryo doesn't develop properly, the tube that should have closed doesn't, leading to the formation of a fistula. Food or bacteria in the throat can then spread through the fistula to the subcutaneous tissue of the neck, where local bacteria can easily multiply and cause infection!"
"That's right! To make the final confirmation, just do an angiography! We also need to let the ENT department take a look together, they are experts in this." Wei Ping said again.
"I think it's probably eighty percent."
Pang Zhong was slightly thoughtful.
"I've seen a case before that seems to be this disease."
"I never thought such a disease could be so complicated." Yang Ke murmured.
"Yes, if a person has recurring redness, swelling, heat, and pain in the neck, an internist might think it's thyroiditis or lymphadenopathy, while a surgeon might think it's a local abscess, cellulitis, or thyrohyoid cyst. However, few people would think of a pyriform sinus fistula, except for otolaryngologists, because they see so many!"
Pang Zhong sighed at this time.
"I should have asked an ENT doctor to come and take a look! Angiography may not be possible now because he's too swollen there, and it may not achieve the best results."
"Yes, continue with antibiotic treatment now, and at the same time make a subcutaneous incision to drain the pus, eliminate the inflammation, and then do angiography!" Wei Ping suggested.
"I agree with Dr. Wei's opinion." Pang Zhong said.
Then he added:
"Go and arrange for the patient to have a mobile phone installed to drain the pus from his neck. Then do an X-ray!"
If it is really a pyriform sinus fistula, then it is easy to treat.
Targeted treatment can completely prevent recurrence.
Piriform sinus fistula. Because this disease is relatively rare, many people misdiagnose it for a long time, sometimes even decades, and they cannot find the cause.
So sometimes, different departments have different specialties.
The judgments made are also different.
Especially some rare diseases.
"Director Pang, if there is nothing else, I'll leave first." Wei Ping left in a hurry.
At this time Pang Zhong held his hand.
"Doctor Wei, this time it's all thanks to you. I think it's that disease, almost certainly."
"It's okay, I just expressed my opinion."
"I can't believe you have such extensive clinical experience at such a young age! At first, I didn't believe it, but now it seems you truly deserve the title! The young are truly formidable!"
Wei Ping smiled. Actually, it wasn't a big deal. Of course, it was inseparable from his own study. Without extensive study, even if he had the tools, he wouldn't be able to diagnose the condition.
The APP will not tell him what the disease is.
It only tells you whether your diagnosis is correct or not, nothing else.
Wei Ping followed up, “I still have a lot to learn.”
Pang Zhong looked at him with admiration.
Young people like this should be reused.
This is the light of future medicine.
At this time, the patient spoke.
His voice was a little hoarse.
At the same time, every word spoken is painful.
"Thank you... Doctor Wei! This disease has troubled me for more than half a year. I believe it will be cured this time..."
He completely believed Wei Ping's diagnosis.
This disease is really too troublesome.
"Take good care of yourself. Okay, I'm leaving now. Bye!"
"Take care, Doctor Wei!"
Four people came out from inside to see Wei Ping off.
This scene was so magical that the patients outside felt it was magical.
But when they saw Wei Ping, they thought it was a normal thing.
"I didn't expect it to be this disease. I learned something new." Yang Ke said.
"Yes, this disease is very rare. Most departments don't encounter one in a year. Naturally, they wouldn't think it was that disease."
"It seems like I still have to learn from you! You have so much knowledge that you can even treat rare diseases in the ENT department."
"Just read more and learn more! Let's go, the patients are waiting for us."
"good!"
The two people walked towards the office.
Continue read on readnovelmtl.com
