Sleepless Doctor

　　 Seeing Gu Weimian's appearance, Wu Mian was startled.

　　 "Director Gu, have you recently suffered from insomnia and have a bad rest?" Wu Mian asked, "Why are the eye circles so dark?"

　　 Gu Weimian thought you didn’t do it? But he could slander in his heart, he didn't dare to harden Wu Mian. Doing things like death, whether you can do it or not.

　　 "Mr. Wu, you really came here on time." Gu Weimian forced a smile.

　　 "Oh, I will be picked up in a while, and there are still two and a half hours." Wu Mian said, "I don't know if I can."

　　 Two and a half hours, do a gastroscope? Gu Weimian looked at him suspiciously, wondering what Teacher Wu meant.

　　 After hesitating, Gu Weimian decided to speak directly after changing his shoes.

　　 He asked, "Mr. Wu, don't you suspect that it is not esophageal cancer?"

　　 "It may not be." Wu Mian said, "Didn't I tell you yesterday, the density is wrong."

　　 "Density?"

"In fact, it is best to have a 64-slice CT film to see more clearly. But doing 64-slice CT is better than doing a gastroscope to see more clearly." Wu Mian said, "Esophageal stones, have you dealt with them here? "

　　 "..." Gu Weimian was speechless. Wu Mian considers esophageal stones? This is impossible! Stomach stones have been seen before, and the esophagus goes straight up and down, and the probability of stones appearing is outrageous.

　　 "Director Gu, if you haven't been in contact, you send someone and the girl, she has a template." Wu Mian said.

　　 Chu Zhixi smiled, and Gu Weimian looked dazed.

　　 arranged for someone to take Chu Zhixi to do the writing work, Gu Weimian carefully recalled what Wu Mian said just now, he felt it was impossible!

　　 It is not impossible to say that it is not rigorous, but the possibility is extremely low.

　　 Why is the possibility extremely low?

　　 Gastrointestinal tract stones generally stay in the stomach, and those that occur in the esophagus are quite rare, and the probability is very low.

　　Gastrolithiasis refers to the disease caused by ingested hair, plant fibers, such as persimmons or black dates, and minerals that are not digested in the stomach and form clumps for a long time.

　　 can be divided into three types: hair stones, plant stones and mixed stones.

　　 Digestive tract stones such as persimmon stones are mostly formed in an environment with pH<4. Under normal circumstances, the pH of the esophagus is about 6, and it is not easy to form primary gastrointestinal stones.

　　 Even if some hair is accidentally eaten in, it is in the esophagus...that is a tube, it hardly stays, and there is no condition for the formation of stones.

　　 Gu Weimian recalled carefully and made sure that his idea was correct. At least I have done thoracic surgery for more than 20 years, and I have never seen a similar patient.

　　 Even though he thought so, Gu Weimian was a little uneasy. I used to think that there were enough checks, but now I think it’s still a little bit worse.

　　 A piece of upper gastrointestinal barium imaging data is not enough to see. In addition, although the lung CT has the esophagus, the imaging department will expose the lungs instead of seeing all the organs clearly.

　　 "Director Gu? Are you a little tired? I don't feel like you are in the state." Wu Mian asked when Director Gu was in a trance again.

　　 Gu Weimian smiled, "Teacher Wu, I'm sorry, I didn't sleep well yesterday."

　　 "I am ashamed." Wu Mian said with a smile, "I will disturb you to rest in the middle of the night, please bear with me."

"Teacher Wu, you are too polite. To be honest, I have never seen esophageal stones. Is there any feature in imaging? Teacher Wu, you are very sure that it is esophageal stones. Is there any trick?" Gu Weimian decided to go. Ask first.

　　 It was like the time on Lao Yao Mountain. I really didn't see the problem, thinking that the patient was hysteria. Anyone who thought about a few calcification points let himself overturn the boat, and until now he was embarrassed to go to Laoyashan to see Taoist Lin.

　　 "The analysis by you and your colleagues in the imaging department is correct. The oval-shaped filling defect has no obvious damage to the mucosa. It can be judged that it is an esophageal tumor." Wu Miandao.

　　 "..." Gu Weimian was startled for a moment. He knew that there was but, it was a turning point for God, but he couldn't speak.

　　 Putting his ears up, Gu Weimian listened quietly.

　　" But to look at it from another angle, the imaging appearance of esophageal stones is similar to that of gastric stones, and they also show a non-smooth, longitudinally running oval filling defect with no obvious damage to the mucosa.

　　Due to the limitation of the esophagus, it does not move like a gastric persimmon stone. It is difficult to see the typical "snowball sign" and "bird's nest sign", nor does it have obvious morphological changes like an esophageal cyst. "

"Because there is only one lung CT available for reference, I am also guessing-the first esophageal barium swallow examination showed a linear stenosis in the cardia area. If there is no esophageal space-occupying disease, we can consider cardia loss. The patient has cardia loss. Regurgitation of gastric juice causes the PH value in the esophagus to decrease, which also creates powerful conditions for the production of esophageal stones."

　　 Gu Weimian tried hard to recall the image data of the upper gastrointestinal barium penetration. He and other directors seemed to have overlooked the linear narrowing of the cardia area.

　　 But the patients are all special with esophageal cancer, who cares if there is a cardia loss?

　　 During the operation of esophageal cancer, the tumor is cut off, a part of the stomach is cut off, and the remaining stomach is pulled up to replace the esophagus. There is a linear narrowness in the cardia area, and there is definitely no problem after the operation, because this piece has been cut off and sent for pathology.

　　 This is a blind zone. All attention is paid to the tumor and tumor-related information. The linear narrowing of the cardiac area is completely ignored.

　　 But even so, esophageal stones are just a guess. Gu Weimian led Wu Mian into the endoscopy room suspiciously. The patient was already lying on the bed waiting for an examination.

　　 "Director Gu~www.wuxiaspot.com~ you are here." The doctor who did the examination casually greeted him, but from the corner of his eye he saw Gu Weimian bending over and leading a tall young doctor in.

　　 There are strong contrasts between old and young, short and tall, humble and approachable. The doctor in the endoscopy room was taken aback, and then he realized who this was.

　　 "Wu... Teacher Wu?!"

　　 "Well, hello." Wu Mian smiled and nodded, "Go ahead, I'll watch it first."

　　 "Mr. Wu, how do you have time today?" the doctor in the endoscopy room asked.

　　 "My friend, let me help you look at the situation, you call Sui Liang, Deng Ming asked me to help you take a look." Wu Mian said to the patient with a gentle expression, "Small problems, don't worry."

"you are……"

　　 "I am a doctor from the Imperial Union Medical College Hospital." Wu Mian did not mention his own name. Young is a shortcoming from the patient's point of view. He said that Wu Mian didn't know others, and thought that this little doctor had something wrong, so he signed up directly.

　　 It's better to talk about the hospital than your own name.

　　 "Thank you, thank you." Sui Liang's expression was a little frustrated, and his words of thanks were insincere.

　　 I had a tumor. Although the doctor said it hadn't metastasized yet, Sui Liang also knew that the doctor might be telling the truth with his family at this time, but he is absolutely impossible to tell the truth with himself.

　　 Report the good but not the worry, that's probably it.

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