Clinical patients are often like this and cannot tell where the pain is.
If the leg hurts, I will touch the whole leg. If the waist hurts, I will touch the whole waist and even the front abdomen. If the stomach hurts, it will be even more exaggerated. I want to touch all the digestive organs in my body.
When encountering such a patient, the first step for the doctor must be to determine which part of the patient is in pain. The human body has many digestive organs, and it is difficult to know which one is the problem and how to treat it. The problem is that for patients who like to touch their entire abdomen, when you palpate them, they may feel pain everywhere you press.
The patient complained of stomach pain, gastroscopy showed nothing was wrong, and he had black stools?
"Have you ever had fecal occult blood tested? Only one plus."
"Yes, yes, that's why the doctor said it's not serious."
The patient certainly didn't understand the deeper meaning of the doctor's words. Xie Wanying knew that when Teacher Tan said "a plus" in the mouth, it meant that the stool occult blood was weakly positive, which was not necessarily gastric bleeding, but could also be hemorrhoids or minor intestinal bleeding.
"What do you like to eat?"
Eating habits are the biggest risk factor for digestive tract diseases, so ask clearly.
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"I usually work in the company and eat lunch boxes."
"Want to drink?"
Men cannot avoid drinking and smoking. Drinking and smoking are also high-risk factors for disease.
"I seldom drink and smoke." The patient denied.
The patient's facial expression when answering questions did not seem to indicate that he was lying. I smelled the patient and did not smell any strong odor of cigarettes or alcohol.
The doctor paused at this point, and the atmosphere in the room suddenly became subtly quiet.
The young man looked at the two doctors in front of him, not knowing what was going on, with a puzzled look in his eyes. He obviously didn't say anything wrong just now.
Xie Wanying paused with the pen she was holding on the medical record.
Teacher Tan beside her was in deep thought, and she was also thinking intensely.
According to the previous consultation, the patient did not seem to have any major problems. The internist of our hospital also performed a gastroscopy and found no major problems.
Could it be that the patient had a mental problem? Was he too nervous about his body? Otherwise, why did he stop having black stools and had a gastroscopy and nothing was wrong? He actually came back to see the associate chief surgeon.
Some young people are more afraid of death than the elderly. They make a big fuss over a minor illness and have to find a specialist to see a doctor to put their mind at ease. Such patients are not uncommon in outpatient clinics.
Seeing that the doctor didn't say anything, the young man became worried and explained, "My friend said that the internist can't treat it, so let's ask the surgeon to take a look."
It turned out that this was the reason why the patient suddenly came to the surgery department.
If internal medicine doesn't work, you can go to surgery, but there must be an indication for surgery.
What can an experienced doctor do after hearing this? Neither crying nor laughing.
Xie Wanying didn't need to look at Teacher Tan's expression to know: Teacher Tan had completely lost his mind.
Time passes by second by second, and I have to explain everything to the patient.
How about prescribing some digestive aid?
"Does your stomach feel bloated?" Xie Wanying asked. After she opened her mouth, she realized that she had forgotten Teacher Sun's instructions. She should not have interrupted without the teacher's instructions.
She glanced at Teacher Tan. Teacher Tan didn't give her a look that said "silence".
"Bloating." The patient replied.
Stomach bloating is a common symptom of digestive tract diseases. One question cannot determine anything. The patient shrugged after answering, thinking that the doctor's question was useless. Unexpectedly, the young female doctor opposite suddenly asked: "Do you often eat hot pot?"
"I, I don't eat it often." The young man's tone sounded a little uneasy, as if he himself knew that liking hotpot was not a good thing.
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