Chapter 294: : The truth is out!

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The bedside ultrasound at the emergency department came quickly, but no obvious problems were found. The appendix, gallbladder, kidney, and ureter were all good.
Hepatobiliary pancreas spleen and kidneys look normal too!
Considering that the girl has no history of overeating, and the pain is not mainly left, it should not be acute pancreatitis.
Is it appendicitis?
Acute attack?
Appendicitis B ultrasound is invisible, unless a long-term chronic inflammation persists, and a severe peritoneal inflammatory mass has formed.
Chen Cang continued to inquire about the history of the disease in detail.
"Is there a feeling of metastatic abdominal pain, which is the feeling of moving from the upper abdomen, then gradually to the umbilicus, and to the right lower abdomen?"
The girl seemed to have an opinion on Chen Cang, and her mood was not so good when she spoke.
Chen Cang was helpless.
Seeing this, her mother suddenly said, "Nini, speak well and cooperate with the doctor. The doctor can treat you badly?"
The girl shook her head: "This is not the case."
Chen Cang thought about it: "Go for an abdominal CT and see if there is any possibility of appendicitis!"
The girl gave Chen Cang a white look and sneered: "You can do it, do this for a while, do that for a while, you lie to my family!"
The parents quickly apologized, "Sorry, doctor, in fact, we have long wanted to have a physical examination of the child, let's be a check!"
Fortunately, the parents actively cooperated and the inspection could continue.
The girl was reluctant anyway, but was pulled by her parents for a abdominal CT.
The CT was done and no major abnormalities were found.
It is not acute appendicitis, and there are no cases of bile duct stones, cholecystitis, cholangitis, pancreatitis, intestinal obstruction, gastrointestinal perforation, and so on.
Now the cause of abdominal pain is also confused.
There are so many reasons for this kind of severe abdominal pain. The only suspect now is the problem of the digestive tract.
Such as gastric ulcer, and duodenal ulcer. This peptic ulcer is a very common cause of abdominal pain.
But ... if you want to do a gastroscope, Chen Cang is now very worried about the girl's discomfort.
And it is really impossible to diagnose what is going on.
At this time, the girl's father's phone rang, got up and went out to make a phone call, then came back and hurriedly sent the test sheet and video materials to the other side, and asked Chen Cang some professional questions.
After Chen Cang explained, the man went out with a phone.
A few minutes later, the man came over and said, "Doctor ... can you help us check a gastroscope and bowel scope?"
"That's right. I also consulted my friend who was a doctor in the capital during this period of abdominal pain. He is an expert in gastroenterology. He suggested that I do a gastroscope and a colonoscopy to see if there are any changes."
Gastroscopy is more convenient in emergency department. Appointment for gastroscopy in gastroenterology department definitely needs gastroscope room number, but emergency department will be more convenient, but the fee will be more expensive.
Chen Cang looked at the girl, and suggested that she be reimbursed for an in-patient examination in the digestive department.
As a result of hearing the hospitalization, the girl's parents quickly refused.
The other party didn't seem to care about the money, so he wanted to make a diagnosis as soon as possible.
The gastroscopy was hard, and the girls were more resistant at first, but later they reluctantly agreed to do it because of their parents' sexual immorality.
The gastroscopy result came out, a little bit of superficial gastritis, the other is not a big problem, but this is certainly not the cause of abdominal pain.
If the gastroscopy girl can barely accept it, the response of the colonoscopy will be violent!
After the girl's mother thought of the colonoscopy, she quickly discussed with her father.
They suddenly decided to do it!
However, before that, the girl ’s mother found a woman doctor who was going to enteroscopy in the gastroscopy room, said a few whispers, and secretly stuffed a red envelope, hoping that she could take a look while doing the colonoscopy ... … Is it broken?
The colonoscopy came out, and there were still no obvious abnormalities.
No enteritis, no colon lesions, and no tumors or anything.
Although there is nothing strange, the mother of the girl is obviously a little angry ...
The cause of anger doesn't seem to be because of abdominal pain, but because of the report by the woman doctor.
"Your girl may have had it, but ... it can't be guaranteed, after all, there are still many damages caused by various reasons, so don't worry too much."
After the examination, the parents of the original girl were angry.
But at this time, the girl suddenly had abdominal pain again!
Cover your stomach, oops barking.
Observation room, Chen Cang is also clueless.
It can be said that all the inspections that can be done are basically done.
But now there are no abnormalities, which is too unscientific!
Abdominal B-ultrasound, gynecological color Doppler ultrasound, abdominal CT, gastroscopy, and colonoscopy were all done, but no abdominal pain was found.
There are only a few things in the belly, and the entire digestive tract is so long. The gastroscope can see part of the digestive tract, and the colonoscopy can see the lower part.
Is it ... the part that is not visible in the middle is apart from the problem?
That is, the jejunum and ileum of the digestive tract. There is no way to look at it. Is there a problem here?
Be a capsule endoscope?
Chen Cang also wants to know now what the is wrong.
This strange abdominal pain hasn't been seen for a long time!
But looking at the state of the girl at this time, Chen Cang felt embarrassed!
Capsule endoscopy can see the entire digestive tract, that is, let the patient swallow a capsule-sized camera. The camera will walk around the gastrointestinal tract, take pictures continuously, transfer data to the computer, and finally pull through the stool come out.
If there is a problem with the small intestine (jejunum, ileum), capsule endoscopy is helpful.
But this check is expensive!
The endoscope room of the Second Provincial Hospital can do it, but it must be several thousand. Inpatients can be reimbursed, but this emergency department is ...
At this moment, Chen Cang suddenly turned around and found that the girl's mouth twitched, her eyes were dull!
!!
This time Chen Cang was scared!
What's wrong?
However, this situation has come and gone in a hurry, and quickly passed.
This signal shocked Chen Cang.
Suddenly thought of a possibility!
He looked at the girls and women: "Excuse me ... Does the family have epilepsy?"
As the words came out, the two quickly shook their heads: "No, no epilepsy ..."
Chen Cang continued to ask, "Have she had any history of trauma? Head?"
The girl's father suddenly realized: "Yes! This and some. In July, she fell down by bicycle once in the summer vacation and bumped her head. She was dizzy for several days at that time, and doing head nuclear magnetic resonance and CT said nothing, It could be a slight concussion. "
Chen Cang said quickly: "I now consider that your girl's performance may be epilepsy!"
As soon as this word came out, the women were shocked!
Epilepsy is not a good disease!
That's sheep madness!
To put it bluntly, it was a sickness and a joke in the countryside.
Someone has a sheep epilepsy, say it ... It's difficult to find a target!
So the women were a little scared: "Doctor ... are you kidding me? How can epilepsy have a stomachache, isn't that twitching and foaming?"
Chen Cang shook his head: "I am just skeptical now, because there is a kind of epilepsy, and the main manifestation is abdominal pain!"
"When a seizure occurs, it may be accompanied by a vegetative seizure, which is also medically known as mesencephalic epilepsy. Specific types can be headache, abdominal pain, limb pain, syncope or cardiovascular seizures."
"So, so many tests have been done, and I now recommend that we do an EEG look and try to find out why."
The parents of the girl were very reasonable, and they quickly agreed!
The typical epilepsy is indeed convulsions, disturbance of consciousness, foaming in the mouth, and everyone understands it.
But atypical epilepsy may manifest as abdominal pain, because the abnormal discharge of the brain may be related to neural disorders in the abdomen, causing abdominal pain.
Although such examples are rare, they have been!
Otherwise it will not be written in the textbook.
So when Chen Cang saw a girl having a dizzy attack, she suddenly thought of this possibility.
Very rare cases, Chen Cang is also greatly interested.
The parents took the child directly to the EEG room and temporarily pulled an EEG.
Compared to ECG, EEG is slower, but Chen Cang estimates that if it is epilepsy, it can be found.
Because the girl has had several attacks today, and there were still small attacks just now.
Soon, the EEG results came out!
Chen Cang looked at the waveform and was not very able to read it ...
The examining doctor said: "Doctor Chen ~ EbookFREE.me ~ See? This 3 times / sec spinal slow wave synthesis, and bilateral symmetrical synchronization ... This is a typical EEG manifestation of a small epileptic seizure ! "
Hearing here, Chen Cang was instantly happy!
Finally find out why!
Electroencephalography has a decisive role in the diagnosis of epilepsy.
And now, the truth is clear.
Li Yan of the examination department was a little surprised: "This is the first time I have seen such a patient!"
Now that the cause was found, Chen Cang called neurology and asked for a consultation.
Zhang Lingyun hurried down after hearing this special medical record.
"Xiao Chen, I have seen such a patient in school for so many years! I never met again!" Zhang Lingyun was a little excited.
The diagnosis was epilepsy. The parents of the girl were still in charge of studying. She took time off and went to the neurology department for hospitalization.