Dr. Feng leaned behind Leng Cen and looked at B-ultrasound on tiptoe. Leng Cen was taller than him, so he couldn't see it without tiptoeing.

Dr. Feng didn't see the image of B-ultrasound very clearly. After all, the distance was far, but he could see the result of B-ultrasound at the bottom: "There is no abnormality in the examination, and this result is only responsible for this examination."

There is no abnormality, which means that there are no stones in the patient's total bile duct. In other words, Director Leng made a mistake in his judgment.

It is said that there is nothing wrong with judgment. Where can the doctors not misdiagnose, and where can they not misdiagnose?

According to the survey, 30% of the doctor's diagnosis is misdiagnosis. If you see a doctor in the outpatient clinic, the misdiagnosis rate is 50. If you stay in the hospital, the young doctor has seen it, and other doctors have also seen it. Everyone has also visited and discussed it. All the B-ultrasound t-tests that should be done are completed, and the misdiagnosis rate is 0.

The human body is very complicated. Every doctor hopes to cure the disease after hand and also hopes that the misdiagnosis rate will be minimized, but it cannot be controlled any more. Many misdiagnosis cannot be avoided.

As long as you become a doctor, there is no misdiagnosis. As the saying goes, a small doctor makes a small mistake, a big doctor makes a big mistake, a new doctor makes a new mistake, and an old doctor makes a long mistake, because a big doctor has many difficult cases! If you encounter many difficult and complicated diseases, the probability of misdiagnosis is also high.

In fact, the misdiagnosis in China is a little lower than that in foreign countries. The misdiagnosis rate in the United States is about 40, the misdiagnosis rate in the United Kingdom is about 50, and the domestic is about 30%.

The reasons for misdiagnosis are many and too complicated, and some are even hard to explain.

Leng Cen's mistake in judgment just now is actually not a big deal. Moreover, this B-ultrasound examination is just an exclusion and is not a final diagnosis. If you accurately calculate it, Leng Cen's judgment just now is not even considered a misdiagnosis.

According to the normal process, the patient starts from entering the hospital to contact the doctor. The doctors check step by step based on their own experience, first identifying the most likely disease, if not identifying the possible disease, and so on.

The human body is very complicated, just talk about abdominal pain. There are many causes of abdominal pain. Doctors cannot let the patient do all the examinations in one breath.

It doesn't matter if the disease is not urgent, especially for some emergency diseases. After all the tests are completed, the patient may be unable to hold on until you are diagnosed.

Therefore, emergency patients are screened selectively.

For example, this patient has abdominal pain, jaundice and fever. Leng Cen speculates based on the triad of Xiake that the patient has a high possibility of common bile duct stones, so he arranged for the patient to have a B-ultrasound. The result of this B-ultrasound is actually the ultimate basis for the diagnosis.

So Leng Cen's mistake in judgment is nothing.

But the problem is that the result was not released just now, Leng Cen published a long speech with great confidence, and this combined with the results of this inspection would seem a bit slap in the face.

For a long and long term, the theoretical basis is not that you cannot say it. The premise is that you must base it on the correct result. The more exciting it is to say it on the wrong result, the more embarrassing it will naturally be.

It's like doing a question. A classmate asked you to ask about math problems. You explained it to others for a long time and said it very well. The classmate who asked about it also thought that what you said made sense and admired you very much, but in the end, it was calculated that the answer was wrong.

This is very embarrassing

There is a saying that is good for successful people to fart. Even if you are poor and ugly, even if you say the most profound sayings, you are nonsense.

Dr. Feng quietly took two steps back and silently said in his heart: "I didn't see it, I didn't see anything."

"Does B-ultrasound show that there are no stones in the patient's common bile duct?" Fang Han next to him suddenly spoke.

Leng Cen slowly put down the B-ultrasound order in his hand: "How do you know?"

Dr. Feng also looked at Fang Han, as if Fang Han knew the result from the beginning. Could it be that Fang Han had a judgment long ago?

No, Fang Han just read the patient's treatment information in the county hospital, but he didn't get the diagnosis.

"Tell me your expression." Fang Han said naturally.

Just like what Director Leng was stunned just now, a fool knew that he had made a mistake in his judgment. If he hadn't made any mistakes, would this look be like this?

Leng Cen opened his mouth and refused to pay attention to Fang Han, but muttered to himself: "No, the patient's symptoms are completely Xiake Triangle, how could it be?"

The patient clearly had a triple sign of Xia Ke, but the B-ultrasound showed no acquaintance in the common bile duct. It was really strange.

Dr. Feng said on the side: "Director Leng, why not do a T-shirt, after all, there are some inadequate examinations for B-superior."

Leng Cen nodded quickly: "Then let's do another t."

Generally speaking, for gallbladder and kidney stones, B-ultrasound is indeed one of the fastest and most commonly used methods of examination. However, B-ultrasound does have limitations and may not be visible in some places. Correspondingly, the resolution of B-ultrasound is still not high enough, some small lesions are not easily discovered, and some places covered by organs are not displayed very clearly.

t is a computerized x-ray tomography camera, which is much higher than the b-ultrasound resolution. It can take cross-sections or stereoscopic images of the examined part of the human body, and can be detected even if there are subtle lesions.

Dr. Feng made a list, and the nurse sent the patient to do T.

However, the results of t show that no stones were seen in the common bile duct.

Leng Cen took the T-panel and looked at it again and again. From the T-panel, you can see the cross-section of the patient's common bile duct. The cross-section of the common bile duct cannot be seen in the white development inside the common bile duct on the scanning layer by layer.

B-ultrasound did not find it, and T didn't find it either. Leng Cen was really embarrassed at this moment. It was a trivial matter that the patient had been in the hospital for more than two hours. If he delayed this, the situation would be not good.

"Director Leng, why don't you find a doctor in hepatobiliary department to consult?" Dr. Feng whispered.

At this moment, he regretted talking too much just now. He originally thought that the patient's problem was not very big, so he called Fang Han and Leng Cen again. Who knew that the patient's problem was so serious?

Director Leng obviously wants to show off in front of Fang Han. Now it’s good, but it’s embarrassing to be unable to show off.

Leng Cen did not rush to answer, but frowned and pondered.

He was almost certain that the patient must have gallstones, but it was really a frustrating person to not find the location of the stones.

All the symptoms of the patient are caused by stones. If the stone cannot be found, the surgery cannot be performed, and the patient's condition will be worsened.

Leng Cen really doesn't want Dr. Feng to come to the hepatobiliary department, but it won't work if you don't look for it now. You can't ignore the patient's life for the sake of face.

"Actually, Director Leng's judgment is correct. The patient is gallstone." Just as Leng Cen was about to agree to let Dr. Feng call someone, Fang Han slowly spoke.

Leng Cen suddenly turned around and looked at Fang Han in surprise. Fang Han actually recognized his judgment.

Fang Han is now taking the patient's pulse, and he speaks while taking the pulse.

Dr. Feng was also a little confused, and Fang Han also made such a judgment?

"But no stones were found in B-ultrasound and T."

Fang Han changed the patient's right hand again: "The stone should be at the junction of the patient's common bile duct and duodenum."

Before Fang Han could finish his words, Leng Cen hurriedly grabbed the T-pandehyde and looked directly at the junction of the common bile duct and duodenum.

After detailed observation, Leng Cen finally discovered an abnormality. The common bile duct near the duodenum was slightly expanded compared to the common bile duct in other places, and the diameter was about 1 cm larger.

One millimeter is simply tiny. If Fang Han hadn't reminded him that Leng Cen had also looked at it very seriously, he would have almost never noticed it.

Never underestimate this 1 mm expansion. In medicine, any event cannot be easily ignored.

If the common bile duct is dilated by 1 mm, it means that the patient must have an obstruction. If there is an obstruction, it means that there is a very likely presence of stones.

"Do a duodenoscopy for the patient right away and do it here." Leng Cen ordered.

Dr. Feng hurriedly arranged for the nurse to do it, while he himself picked up the T-pandemic that Leng Cen put down and looked carefully at the common bile duct and duodenum.

After a while, Dr. Feng found an abnormality in the part where the common bile duct was about to enter the duodenum. This place is very special, and it is indeed difficult to detect B-ultrasound and T.

The nurses quickly brought the equipment, and the duodenoscopy entered the patient's mouth, from the esophagus to the stomach, and then entered the duodenum, walking down little by little. An abnormality occurred near the duodenum, which was the place where the duodenum and common bile duct intersected.

Leng Cen was actually a little excited and hurriedly ordered: "Make a contrast agent!"

The nurse hurriedly took a contrast agent, and the stone was clearly displayed on the display screen.

Leng Cen breathed a sigh of relief: "Prepare for the operation, I'll do it."

"Okay." Dr. Feng responded, and then quickly began to arrange the operation.

Only then did Leng Cen subconsciously look at Fang Han, Huh? Why aren't you seeing anyone anymore?

Dr. Feng happened to receive a call from Fang Han: "Doctor Feng, Director Fang called just now, so I won't stay for dinner. We'll talk about it another day."

"Doctor Fang, how can this work?"

Dr. Feng hurriedly tried to keep it. It was Fang Han's credit for them to find the stone smoothly today. If it weren't for Fang Han, they might have been catching things blindly now.

The location of the stone was found, and Dr. Feng actually understood Leng Cen. This place is really difficult to find and is easy to ignore.

Thinking of this, Dr. Feng was shocked again: "How did Fang Han know?"

From beginning to end, Dr. Feng remembered that Fang Han had never seen the patient's B-ultrasound results, nor did he see the patient's T-film. He was sitting on the patient's side to take the pulse while reminding him.

Is this a diagnosis based on pulse diagnosis?

Dr. Feng was confused, and Leng Cen was also confused at this moment.

Could it be that Fang Han was really diagnosed with the pulse? How could he be? Is it said that the diagnosis methods of traditional Chinese medicine are even better than modern examination instruments?

It's so amazing. He originally planned to show it in front of Fang Han, but he didn't show it, but was slapped in the face by Fang Han.

The most annoying thing is that Fang Han actually disappeared at this time, and he still has a lot of doubts in his heart.

Leng Cen's heart was like a cat scratching him. How uncomfortable it would be?
Chapter completed!