Practicing Medical Skills in a Small Clinic novel Chapter 602

Chapter 602: Chapter 276: Investigate When Needed, Helping Score Number Two on the Leaderboard_2

Symptoms like lack of chewing power and ptosis can exclude myasthenia gravis or polymyositis.

Symptoms such as dry mouth and tearlessness can exclude Sjögren’s syndrome.

"Achalasia can also have similar symptoms! Is there a possibility of concurrent esophageal ulcer?"

Xiao Linlin hesitated a bit.

"Achalasia can cause difficulty swallowing, but it also leads to post-meal vomiting. The patient does not have vomiting symptoms after eating, so I believe the likelihood of esophageal cancer is greater."

Li Jingsheng appeared very rational, with an exceedingly clear thought process.

Listening to his analysis, Xiao Linlin secretly admired this young orthopedic doctor more than ten years younger than herself.

It’s truly unexpected that he’s not only skilled in bone setting but also outstanding in gastroenterology diagnosis.

Without further hesitation, she directly applied for an endoscopy.

After a while, Xiao Linlin relayed the information.

"Endoscopy was performed, and at about 29cm from the tooth gate, on the right wall of the esophagus, a localized erosion of about 1.2 by 1 cm was found, with clear boundaries and granular changes at the center."

Li Jingsheng was not surprised by the examination results.

From the outset, he suspected it could be esophageal cancer, and now two consecutive examinations both point to esophageal cancer.

The granular change at the center of the lesion indicates that cancer cells are rapidly proliferating. Malignant tumors are diverse, with almost all of them sharing a common feature: an irregular surface and peculiar shape.

Examples include squamous, granular, and irregular shapes.

"Was a biopsy performed? It’s basically confirmed as cancer now."

"The biopsy has been done, but the results are not out yet. The sample was sent for testing over an hour ago, so the results should be out soon. This also shows that Qiaobang Hospital’s gastroenterology doctor’s diagnostic approach aligns with yours."

Xiao Linlin whispered as she conversed with Li Jingsheng.

She highly admired Li Jingsheng’s diagnostic ability in the field of gastroenterology.

"Most gastroenterologists would likely approach it similarly. I suggest you wait for the biopsy results. If it is indeed esophageal cancer, then submit an application for an Endoscopic Ultrasound (EUS) examination."

Li Jingsheng told her.

"Didn’t the judges say to minimize examinations? I’ve already conducted several for the patient. With an endoscopy and biopsy, it’s completely sufficient!"

Xiao Linlin asked in confusion.

Conducting more examinations would mean losing points.

It’s a competition now; she doesn’t aim for the championship, but at least hopes not to come last.

An unconventional examination deducts 2 points, which is very disadvantageous for her.

"The judges advocate against excessive examinations to avoid wasting valuable medical resources and increasing the patient’s financial burden. I recommend this examination to differentiate whether the esophagus’s mucosal, submucosal, muscular, and external layers have all undergone pathological changes, and to determine the extent of lesion infiltration. It can also observe the lymph nodes surrounding the esophagus and the posterior mediastinum, aiding in better differentiation of whether it’s a malignant lesion or if there’s mediastinal lymph node metastasis.

This will greatly benefit the formulation of the patient’s surgical plan.

VERIFYCAPTCHA_LABELVerify