Doctor Song, are you married?

Chapter 201 201. It’s actually an airway tumor?
It was during his internship that a patient died suddenly due to dyspnea. The cause of death could not be found out. Later, during the autopsy, it was discovered that the cause of death was pulmonary embolism.

However, to diagnose pulmonary embolism, a pulmonary artery CTA is required. However, the patient is currently in a critical period. Not to mention a lung CTA, even a simple lung scan is not suitable!

What should I do?

Song Qi scratched his hair subconsciously.

If lung CTA is not performed, are there other examination methods that can assist in diagnosis?

Patients with pulmonary embolism usually cause venous thrombosis in the lower limbs. So, can D-2mer be checked?In addition, pulmonary embolism can lead to pulmonary hypertension, which may lead to thrombus in the right atrium. How about a bedside cardiac color Doppler ultrasound?
With this in mind, Song Qi applied for a connection to the intensive care unit and asked the doctor to perform these two examinations on the patient urgently.

After a while, the test results came out.

However, neither of these two test results supported the diagnosis of pulmonary embolism.

So, it’s not pulmonary embolism?
Song Qi felt a little regretful, but at the same time she felt a little lucky.

After all, if it is a pulmonary embolism, the patient is likely to die at any time.

At this time, several doctors had already submitted their diagnosis results one after another.

While the contestants on the stage were racking their brains to think about possible diagnoses, the judges below were also having a heated discussion.

After all, this is not just a game, but also a patient's life.

Song Qi looked at the time and saw that there was still nearly an hour until the end.

Due to the complexity of the case and the need for timely supplementation and improvement of auxiliary examinations, the diagnosis this time took a long time.

If you still don’t have an idea within half an hour, you need to ask the system for help.

Song Qi thought so and started sorting out the patient's various physical examinations and auxiliary examinations again.

When re-examining the patient's chest X-ray, Song Qi found that the patient's lungs were really clean, with no leakage, no obvious space-occupying lesions, no pneumothorax or pleural effusion, and no obvious displacement of the trachea. .

However, Song Qi just felt that something was not normal about this chest X-ray.

Song Qi is actually not very good at reading chest X-rays. After all, he graduated from clinical medicine, not imaging. Although clinical medicine also learns imaging knowledge, it is just a quick glance. When the teacher is teaching They were just perfunctory, and the students were even more perfunctory, wishing they could have a good sleep on these minor subjects.

After all, medical students have too much to memorize. The professional courses alone are enough for everyone, and there is no time or energy to understand these auxiliary subjects.

Of course, Song Qi was more diligent than ordinary students. When the teacher taught, he listened carefully, but even so, he only learned a little bit.

That is to say, based on this superficial knowledge, he felt that there was something wrong with the chest X-ray, but he could not see any problem.

otherwise?Apply for system assistance?

As soon as Song Qi came up with this idea, he could no longer suppress it.

Song Qi is not someone who is hesitant about searching for something, and would not be willing to use it if there are any good things. He is just the opposite. His philosophy is that only by using it can the value be reflected.

So, Song Qi called the system without hesitation.

[Do you want to use the system's auxiliary diagnosis (treatment) function? 】

The system arrives as promised.

Song Qi clicked yes.

Immediately afterwards, the image of the chest X-ray moved in front of Song Qi's eyes.

Just like in the process of taking a film, every layer and every part was displayed again, and finally it was fixed on the position of the trachea close to the carina.

This time, Song Qi could see clearly that there was a very blurry, faint image of soft tissue in this area.Song Qi was a little surprised and excited.

No wonder it looks strange, it turns out to be this little gadget.

[The blockage of airway tumors causes the large airways to become narrow, preventing external oxygen from entering and internal carbon dioxide from exhaling. 】

Just when Song Qi was secretly excited, the system gave the final diagnosis very thoughtfully.

This soft tissue-like thing located in the airway turns out to be a tumor!
Such a tumor is blocking the throat.

No wonder the patient is asthmatic!

No wonder asthma is getting worse!

No wonder it has no effect at all as an asthma treatment!
No wonder even the powerful antiasthmatic drug methylprednisolone has no effect!

No wonder even endotracheal intubation is useless!
All these phenomena that were difficult to explain became easier to explain because of seeing this faint image of soft tissue.

Song Qi originally thought about connecting to the intensive care unit and asking them to take a clearer picture to confirm, but then he thought that since the system clearly told him that it was a tumor, it seemed unnecessary to ask further.

So Song Qi pondered for a while and began to write down his diagnosis on the tablet: a suspected tumor in the airway carina, and bronchoscopy was recommended.

Due to time constraints, Song Qi did not have time to write too much diagnostic evidence. In fact, there was no diagnostic basis. The chest X-ray was the best basis.

As soon as Song Qi pressed the submit button, the host also announced that the time was up.

This case is obviously difficult. Several directors rushed to write down a diagnosis at the last moment, which is highly suspicious of speculation.

Such a result was not surprising to the experts on the judging panel.

In fact, they discussed it for a long time without a clear conclusion.

After a while, the staff of the competition preparation team sent the answers of each contestant to the dedicated computer of the jury.

This was also requested by the judging panel in advance.

Although the first case did not have a clear diagnosis, it was a routine case and the patient's condition was relatively stable.But in this case, the patient is currently in the ICU, and the situation is not optimistic. It is more of a large-scale consultation than a competition.

Therefore, the judging panel also hopes that these contestants can give them an enlightening idea.

After all, the patient is still waiting for help!
This case was indeed difficult, and five contestants turned in blank papers.

The diagnoses for the remaining ten were also varied, including pulmonary encephalopathy, toxic encephalopathy, blood system diseases, central system diseases, and connective tissue diseases.

Although these diseases also have symptoms of asthma, it is unexplainable that the symptoms of hypoxia cannot be changed after being put on a ventilator. Moreover, there is currently no obvious basis for diagnosis of these diseases.

When they saw Song Qi's diagnosis, the experts on the judging panel were stunned for a moment.

Because, among so many diagnoses, it seems that only the diagnosis of airway tumors can explain why the patient's blood oxygen saturation has not been rising.

However, airway tumors are too far-fetched, right?

First, it is clinically rare, and second, all current test results do not seem to support this diagnosis!

However, this is a good idea. You can listen to his thoughts.

After several experts from the judging panel reached consensus, they asked the staff to print the final results on the big screen.

(End of this chapter)