Chapter 224 Cryptogenic Multifocal Ulcerative Stenosing Enteritis
Wei Ping then walked to the patient.
Carefully check the patient's symptoms.
And began to see through.
At this time, the patient suddenly recognized Wei Ping.
"You're Doctor Three Punch, right?"
Wei Ping nodded.
"My daughter likes you very much." the female patient said again.
"Thanks!"
Wei Ping continued to check.
The female patient suddenly said, "Doctor Sanquan, let's take a photo together."
"Sister, wait a minute, we are in consultation." Duan Fei couldn't bear it anymore.
"Okay, okay."
Then she added, "I'm going to tell my daughter later that Dr. Sanquan treated me. With Dr. Sanquan here, I feel relieved. I've had this illness for over 40 years, and now it's finally going to be cured."
The patient said this while holding his cell phone.
"So, Xiao Wei, do you have any conclusion?" Luo Yuan asked.
Wei Ping then said: "First of all, I don't agree that it is Ron's disease!"
After these words came out, Luo Yuan's expression became a little strange.
Does this mean that my judgment is wrong?
But he still patiently asked, "What does Doctor Wei think is the disease?"
The name changed directly.
The interns outside were all worried about Wei Ping.
Yang Ke was also standing by, not knowing what to do.
Duan Fei just laughed it off.
"Then Xiao Wei thinks it's okay for you to tell us what you think. There are two directors here. If there are any mistakes, they will definitely come forward to correct them!"
He obviously didn't believe Wei Ping's judgment either.
That's because he doesn't believe it, but it doesn't mean Wei Ping is incapable.
"I checked the reports repeatedly. The patient's inflammatory indicators were not too high, and she had some edema in her limbs, which is very different from Crohn's disease of the small intestine."
"Anything else?" Luo Yuan asked again.
"No longitudinal ulcers or cobblestone changes were observed, no non-caseating granulomas, no perianal lesions, and no fistulizing lesions. These four findings also do not support Crohn's disease."
"The patient had recurrent abdominal pain accompanied by nausea and vomiting, chronic anemia, and hypoproteinemia. Imaging showed multi-segment ileal wall thickening. However, Crohn's disease treatments such as hormones, immunotherapy, biological agents, and enteral nutrition were ineffective. This further reduced the likelihood of Crohn's disease."
Luo Yuan stopped talking.
The interns outside were all shocked.
Wei Ping is really knowledgeable.
Yang Ke just stood there blankly.
The gap between her and Wei Ping is getting bigger and bigger.
If she were to judge, she would not be able to diagnose the disease.
Maybe, like Luo Yuan, he would be diagnosed with Crohn's disease.
Duan Fei is not particularly good at gastroenterology.
So we didn't talk much.
Hu Jianfang then asked, "Xiao Wei, what do you think is the disease?"
"I think it's cryptogenic multifocal ulcerative stricturing enterocolitis (CMUSE)! My suggestion is surgical treatment!"
APP Tips:
"Congratulations on diagnosing CMUSE, and you won RMB 3,000! Proficiency +300, /"
It really is this disease!
The recognition from APP gave Wei Ping greater confidence.
Hu Jianfang slapped his thigh.
"I also suspected it was this disease, but I didn't dare to confirm it!"
Wei Ping added: "The ulcers of this disease are superficial, affecting only the mucosa and submucosa. Although the inflammatory infiltration can reach deep tissues, full-thickness inflammation and fissure-like ulcers are not seen. Intestinal perforation or fistula is generally not complicated, and fatal bleeding is rare.
Fibrous tissue deposition and thickening of the muscularis mucosa at the ulcer site cause contracture and stenosis of the intestinal tract near the ulcer, leading to intestinal obstruction in most cases, with symptoms such as abdominal distension, abdominal pain, and vomiting. Most patients suffer from chronic blood loss, which can lead to iron deficiency anemia. These symptoms are consistent with the patient's presentation.
Luo Yuan asked again: "Then how do you think the surgery should be performed?"
"I suggest laparoscopic exploration combined with partial ileal resection. It depends on Director Hu's judgment."
Luo Yuan asked again: "What is the basis?"
Wei Ping continued, "Part of the ileum had thickened and tough walls, mesentery hyperplasia and edema, part of the mesentery was contracted, and multiple short-segment annular strictures were observed. Multiple cystic dilatations were observed in the intestinal tract proximal to the strictures, so resection was performed."
"Good, good! That's great! I totally agree with Dr. Wei! The surgical plan is very good! I agree."
At this time Hu Jianfang said happily.
His expression changed from disdain to seriousness.
"I didn't expect Dr. Wei to be so knowledgeable. Very good. I also suspected that it was that disease before, but I didn't dare to confirm it." Hu Jianfang added that whether it was true or not, only he knew.
Perhaps, he just wanted to get someone's affirmation.
Now that Wei Ping had said so much, he was more certain about the condition.
Luo Yuan had nothing to say at this time.
"Since surgery is required, it has nothing to do with internal medicine. I'll leave first!" Luo Yuan said with a dark face.
Duan Fei then said, "Director Luo, this patient's various indicators still require support from the internal medicine department. It's very important."
After hearing this, Luo Yuan did not leave.
"Doctor Sanquan, why is the name of my illness so long? It sounds very serious! What's the success rate of surgery? Is it a terminal illness?!"
The patient asked at this time.
"Don't worry, big sister. The success rate of this operation is very high, and it's the director who performed the operation, so don't worry."
Hu Jianfang then said, "Yes, don't worry, just rest assured and recuperate! This operation is not a major surgery!"
The patient didn't say anything.
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