The family members had said before that the patient had undergone surgery in other hospitals and had a section of something cut off. At that time, Xu Qiu thought that the hospital had found some organic lesions. But now, seeing the results of the imaging examination, he understood everything! There was a section of colon missing in the patient's abdominal cavity. That operation did not remove the lesion at all, but cut a section of colon... The most taboo in surgical operations is to open an "empty knife". That is, open the operation and close it without doing anything. Doing so can easily cause medical disputes. As long as the patient is willing to entangle, the hospital will definitely lose the lawsuit. Therefore, many surgeons will not close the abdomen directly even if they cut something casually. Xu Qiu even guessed the judgment of the hospital.
They probably suspected that the patient had a mental illness and that the abdominal pain was more caused by psychological factors. Therefore, after opening the abdomen and finding no lesions, they cut a section of colon as a comfort. Unexpectedly, the patient's abdominal pain was not caused by psychological factors. After the operation, her symptoms did not get any relief! ... "It's a bit troublesome." Xu Qiu scanned the patient's new CT film. Except for the missing section of colon, it is no different from a normal person, with no organic lesions. Dong Dong Dong—— Xu Qiu's fingers tapped on the table, looking at the patient's information in front of him for five years, constantly eliminating and screening diseases. Stubborn abdominal pain. Rash, pigmentation, scars all over the body. There are also neurological symptoms. Lead poisoning, organic lesions, etc. need to be ruled out... At this moment, Xu Qiu's finger stopped in mid-air, and he suddenly remembered a disease! A disease called "vampire"! He quickly opened the patient's medical record again. After a while, he felt a little more excited. It fits perfectly!
Before this, no doctor had considered this disease! The reason is that it is too rare. If Xu Qiu himself did not have rich experience, he would not have considered it! Xu Qiu did not want to delay, and quickly found the treatment room. He had come with the doctor's order for painkillers at this time-Xu Qiu had ensured that painkillers would not cover up the condition, and there was no need to strictly control the use of painkillers. Just as he was about to ask for another examination, the family members interrupted him. "Doctor, we don't want to treat her anymore!" The husband beside the bed lowered his head, looked at his wife who was sweating in pain with some complaints, and said: "I suspect she is mentally ill. No hospital has found any problems. We want to go to Union Hospital. Except there, other places are useless!" Xu Qiu said: "I already have some clues here. Another examination should be clear." "One more? Every doctor said so. We have spent tens of thousands of dollars on the examination alone. Where can we get so much money!" Xu Qiu picked the cheapest one from many examinations and said: "Ten yuan examination, if there is no problem, then you can go to Union Hospital." The patient's husband looked at Xu Qiu doubtfully. Finally, he nodded. Xu Qiu prescribed a urine porphyrinogen test. Soon after, the laboratory reported the results. The patient's urine porphyrinogen increased! Xu Qiu was not surprised to see this result. It's stable... This disease, known as "vampire disease", will show increased urinary porphyrinogen during the attack period! Xu Qiu found the patient's family again and told them about this unfamiliar disease: "Porphyria." Porphyria? The family seemed confused. This is also normal. Porphyria itself is very rare, and many doctors may not encounter a case in their lifetime. Even if they encounter it, they will hardly make such a diagnosis. The reason is that the symptoms of porphyria are not specific, just abdominal pain, skin manifestations, and occasionally mental symptoms, which can be easily confused with other common diseases. Therefore, being able to think of porphyria can already show that a doctor has a wide range of knowledge. And daring to diagnose it shows that a doctor has strong clinical ability! "This is a disease called vampire disease." Xu Qiu explained slowly. The husband's face changed, "She...she likes to suck blood?"
Xu Qiu shook his head: "It is caused by the lack of enzyme activity in the heme biosynthesis pathway. It is very sensitive to light and will attack when it sees the sun. Just like a vampire, it can't see the light." The husband was relieved. I thought I was going to have a vampire wife... "Doctor, hurry up, treat it!" The husband was anxious. This is the first time he has really seen hope in five years! ... After returning to the office, Xu Qiu ordered several more tests to further clarify porphyria. And classified it, and finally determined it as: acute combined cutaneous porphyria. That night, Xu Qiu prescribed "arginine heme". Intravenous injection of human heme can inhibit the activity of liver ALA synthase, reduce the production of porphyrin and precursor substances, and thus control the acute attack symptoms of porphyria, such as relieving abdominal pain, vomiting, and reducing mental symptoms. In addition, Xu Qiu also asked the family to buy a few bottles of Coke and various cakes with excessive sweetness. High-sugar foods and drinks can also inhibit the activity of ALA synthase. "And the most important thing is fentanyl." "The most important thing" is for patients. Fentanyl can quickly relieve pain. For patients, five years of intermittent abdominal pain almost destroyed her spirit. Relieving the pain was her most urgent wish at the moment. … In the ward, after taking fentanyl, the patient's pain was finally relieved. The couple were very nervous. This scene has been repeated countless times in the past five years, but every morning the next morning, when the effect of the medicine wears off, the abdominal pain will come back again. With such worries, the patient fell asleep uneasily. "had lunch." Suddenly, the patient was awakened by a sound. She looked at her husband in shock, "You...what did you say?" "have lunch!" "Already, already noon?" The patient quickly looked at the time and was immediately overjoyed. Really useful!
She didn't wake up from the pain in the morning and actually slept until noon! At this moment, after carefully feeling it, she still only had slight abdominal pain. However, after falling asleep, this level of pain is completely negligible. But before, she was always awakened by a burst of severe pain! The husband also reacted suddenly and patted his thigh, "Yes, you actually slept until noon! It works, it really works!" At this moment, the couple hugged each other. They realized that the disease that had tortured them for five years might really be over. … Porphyria, vampirism. This rare medical record was quickly shared with the large group at Linhai No. 1 Hospital.