"Mr. Zhou, the patient's left waist is painful, and there are white blood cells and red blood cells + urine routinely. On the vertical abdominal flat film, you can see high-density shadows near the 2-3 lumbar spine on the left." The doctor on duty looked tired and instinctively reported his medical history: "The patient does not agree to the hospital and is given antispasmodic and analgesic treatment."

"Is the effect not good?" Zhou Litao asked.

"It's normal. I'm telling me that the pain has been relieved, but I think it's still hurting. I persuaded me twice and refused to be hospitalized."

"How about physical examination?"

"The pain of percussion on the left waist is obvious, and the pain on the right is also obvious." The doctor on duty went to the emergency room and took out the patient's X-ray of the standing position for Zhou Litao to see.

When the film is inserted into the film viewer, a high-density shadow with a diameter of about 1.5m near the lumbar spine on the left side is so conspicuous.

Generally speaking, vertical abdominal dissection and flat abdominal film are common methods for diagnosing urinary stones.

The patient's condition is very typical, but Zhou Litao was recalling what the doctor on duty said just now as he watched the movie.

The pain of percussion on the left side is obvious, which is what it should be.

But there is also a pain in the right waist, which is possible if it is transmitted. But Zhou Litao still feels something is wrong, so he turns his attention to the film on the video viewer.

He looked carefully at the flat film of the abdomen on his erect position, and no stones were seen on the right ureter. As for the part below, close to the kidney, it was not something that could be seen clearly by X-rays.

If one examination is confirmed to be a left ureteral stone, according to normal diagnosis and treatment procedures, no other examination should be done.

Otherwise, if someone would be labeled as over-medical, who would have to bear it?

That's it. It's probably because it was cold and the ureteral spasm, causing the pain to not be relieved. Zhou Litao took off the film and put it in the film bag, but the whole process was a little hesitant.

He was still thinking about the positive signs of the physical examination.

Early in the morning, the most leisurely time in the emergency department, Zhou Litao brought the film to the emergency room and began to ask for his medical history.

The patient and the patient's family told the story of the disease.

There is nothing worth noting, it was just that I went to bed early last night and had the window open. As a result, the cooling dropped in the middle of the night, and the left waist and abdomen began to hurt.

At first, I thought I was catching a cold, so I got up and closed the window and went to the bathroom.

Unexpectedly, the pain became more and more severe, and I almost fainted on the toilet. The patient woke up his family and sent him to the emergency department of 912.

Urinary stones are said to be serious or mild. Although the patient is in severe pain, he has a friend who has done external gravel and described the process of external gravel to him.

The strong sense of fear made him refuse to be hospitalized for external lithotripsy and other treatments without hesitation, and only stay in the emergency department for symptomatic treatment to observe the changes in the condition.

In fact, it is true that others talk about illness, and they are very polite. This is the type of people who speak without back pain while standing. After all, many things cannot be empathized with.

Fear is a normal emotion, just don’t affect normal diagnosis and treatment.

Zhou Litao carefully examined the patient.

His left hand was pressed on the patient's left waist and his right hand gently tapped on the back of his left hand.

"It hurts." The patient frowned, bared his teeth, and said with pain.

Zhou Litao then asked the patient to change his position and began to knock on his right waist.

The right hand gently tapped the back of the left hand. Unexpectedly, the patient shouted, his body began to tremble a few times, and the bow became even more powerful.

"Doctor, be gentle, be gentle." The patient's lover felt his heart tugged as he looked at him and almost cried.

"Does your left or right side hurt?" Zhou Litao asked in confusion.

"There is pain on the left." The patient's voice has changed due to the pain.

"Then I'll knock on you to the right, how do you feel?"

"My whole stomach hurts, I can't stand it... Doctor, don't knock me, it's really a fatal blow once." The patient said with a sad face.

His face was a little pale and pale. Zhou Litao probably caused it. It didn't seem like he was pretending, and the transmitted pain didn't seem to be so severe.

Strangely, the autonomic feeling was pain on the left side, and the X-ray in the standing position also proved this. However, during the physical examination, Zhou Litao had an illusion that the patient had problems with the right urinary tract.

This kind of physical examination and private prosecution symptoms and clinical examinations are not very common.

Zhou Litao covered the patient's clothes and asked about family history, past history and other series of situations, and then left with doubts.

There was no problem worth noting. Zhou Litao wanted to check again to see if he hadn't noticed it. The patient almost cried and begged him not to check his body.

Since last time he met a girl with abdominal epilepsy for 16 years, Zhou Litao has listed family history as a must-ask item.

Clinical diagnosis and treatment are like this through accumulation of experience and growing little by little.

The patient's family history is fine, and he has a family history of hypertension, but he does not have hypertension.

Zhou Litao thought hard and quickly made up his mind to communicate with the patient and the patient's family, preparing to do a B-ultrasound before confirming it.

The patient's family agreed, after all, the pain was slightly relieved after taking the medication, but it was not very obvious.

Besides, when choosing between the two options of spending money and physical examination, the patient chose to spend money and then do the same examination without hesitation.

Logically speaking, as long as the stone is stuck in the ureter, the pain will not change much. You also need to drink a lot of water and exercise vigorously to let the stone fall out.

The pain was a bit strange, and Zhou Litao's doubts were not explained.

The wheelchair pushed the patient to do the examination. He twisted his body in the wheelchair, weak, as if only half of his life was left.

Zhou Litao is used to seeing such patients, and he is not very sympathetic. What he thinks about in his mind is that physical examinations and symptoms and video data are inconsistent.

Is it a strange problem?

If you don’t work, please take Mr. Yu from the urology department to consult. Zhou Litao decided to do a big deal. Even if Mr. Yu is unhappy, he must make a clear diagnosis.

Soon, the patient came back with a report in his hand.

The patient's family was a little confused and even a little unhappy.

"I'll take a look at the report sheet." Zhou Litao stepped forward and asked for the order.

"Doctor, how do you say that B ultrasound is a problem on the right side? Is it done a wrong?" asked the patient's family.

Zhou Litao's heart thumped.

Is it right? That is consistent with the physical examination. But the X-ray flat film and the patient's own symptoms...

He reads the B-ultrasound report right away.

There was hydronephrosis in the right kidney, and a stone about 2m was found near the proximal end of the ureter. However, there was no problem with the left kidney and ureter.

md! Zhou Litao's hands holding the report form began to tremble a little.

Just say there is a problem, but clinical examinations violate each other. What is the reason?
Chapter completed!