In nearly two hours, Yu Zhiming completed the difficult-to-delivery fetal positioning for eight pregnant women, and also adjusted the fetal position with the umbilical cord wrapped three times around the neck.
Afterwards, he rushed to the examination room in the Department of Cardiology and performed a physical examination on the Gu family.
The first person to undergo a physical examination was found to have a problem by Yu Zhiming.
Liver cyst.
It is a common clinical liver disease.
Most liver cysts are simple liver cysts, which are small in size, grow slowly, have no obvious symptoms, and generally do not require treatment.
However, the 51-year-old patient examined by Yu Zhiming had a liver cyst with a diameter of about eight centimeters.
Although there are no obvious symptoms yet, if you get older, you will have obvious symptoms of upper abdominal pain and fullness.
There is a risk of rupture for such a large cyst.
Surgical resection is necessary.
The second physical examiner who walked into the examination room was a woman in her early forties.
As soon as she came in, she told Yu Zhiming that she had been constipated in recent months and often needed medicine to help her defecate.
I hope Yu Zhiming can find out the exact cause and solve her painful defecation.
This made Yu Zhiming grin secretly.
Although constipation is not a serious problem, its causes are diverse.
There are both organic and functional causes.
If it were told in detail, it would be enough for medical experts in this field to talk about it for ten days and a half.
This less than ten minutes of physical examination alone allowed Yu Zhiming to find out the exact cause of constipation. This must have been a deliberate attempt to make things difficult for him.
Although Yu Zhiming thought so in his heart, out of the desire to protect his honor as a medical genius and not wanting to be really troubled by this woman, he focused on the physical examination.
First, the brain examination.
One of the organic causes of constipation is neurological diseases, such as central brain diseases, stroke, multiple sclerosis, etc.
Yu Zhiming did not discover that this woman's brain had any brain problems that deserved special attention.
Next is to check the neck.
Yu Zhiming focused on her thyroid gland.
Endocrine or metabolic diseases, such as diabetes, hypothyroidism, parathyroid disease, etc., sometimes also cause constipation symptoms.
Yu Zhiming then checked the woman's breasts, heart, left and right lungs, stomach and other internal organs...
After finding no problems that required attention and treatment, Yu Zhiming moved his hands to the woman's abdominal cavity.
After first examining the kidneys, gallbladder, reproductive organs and other internal organs in the abdominal cavity, Yu Zhiming left the most important examination of the woman's intestinal system for last.
He first quickly explored the woman's intestinal system.
Yu Zhiming first confirmed that the woman had no organic disease of the intestines, such as tumors, inflammation or other causes, causing intestinal lumen stenosis or obstruction.
In addition, pseudo-obstruction, congenital megacolon, megarectum and other causes of constipation have also been ruled out.
After further exploration, Yu Zhiming ruled out intestinal polyps, rectal prolapse, hemorrhoids, rectal muscle hypertrophy, pelvic floor disease and other conditions one by one.
This woman's intestinal system is quite healthy.
Perhaps, it is constipation caused by functional reasons?
For example, if you eat less, or the food lacks fiber, or lacks water, it will lessen the stimulation of colon movement, and it is easier to cause constipation.
In addition, emotional stress, too fast a pace of life, and changes in work and living habits may also cause constipation.
Abuse of laxatives can lead to excessive dependence on drugs and can also cause constipation.
Just when Yu Zhiming wanted to ask about the woman's diet, lifestyle and medication habits, he suddenly noticed something.
This woman's colon seems to be a little long
The normal anatomy of an adult is that the length of the ascending colon is 15 cm, the transverse colon is 55 cm, the descending colon is 20 cm, and the sigmoid colon is 40 cm.
If it exceeds the normal value and the range of motion increases, it can be diagnosed as colonic redness.
After careful examination by Yu Zhiming, he found that the length of this woman's sigmoid colon was nearly 44 centimeters.
This is proper colon verbosity.
A long colon is also one of the causes of constipation.
Just when Yu Zhiming was about to tell the woman about his discovery, he realized something was wrong.
This woman said that she only had symptoms of constipation in the past few months.
If the constipation is caused by a long colon, it should be long-term and stubborn constipation that has been present since childhood.
In other words, the main culprit causing the woman’s constipation in recent months is not the long colon.
At most it can be regarded as an auxiliary bonus factor.
Could it be that today I am going to be defeated by a little constipation and my reputation will be damaged?
Yu Zhiming's eyes fell on the woman's belly again.
No obvious belly.
For a woman of her age, her lower abdomen is relatively flat, which shows that she attaches great importance to maintaining her figure.
At least pay attention to your diet and exercise.
Exercise?
Yu Zhiming thought of this word and stretched out his finger to poke the woman's belly.
The abdominal muscles are not as tight as expected, and their resilience is slightly lacking.
Perhaps the strength of the abdominal muscles and pelvic muscles is insufficient, and the driving force for defecation is insufficient, making it difficult to expel feces from the body?
"How many sit-ups can you do?"
Yu Zhiming finally asked a question.
The woman, who was still lying on the examination bed, said distressedly: "Doctor Yu, I used to be able to do sit-ups in the 50s and 60s."
"I haven't been able to do it lately. I can't get up after doing more than a dozen."
"My back hurts every now and then!"
Backache?!
This made Yu Zhiming think that the lumbar nerves were damaged, which in turn affected the control of abdominal muscles, pelvic muscles, and intestinal peristalsis.
"Turn over, I want to check your spine."
Generally speaking, Yu Zhiming’s physical examination does not require the physical examination subject to turn over.
Because if there is a problem with the spinal cord or intervertebral nerves, it will be reflected in other aspects of the body.
When Yu Zhiming makes discoveries and doubts, he will ask the subject to turn over and conduct an in-depth exploration of the spine.
Just like this time...
Yu Zhiming carefully explored the woman's spine starting from the cervical vertebra and working from top to bottom.
When he explored the woman's second lumbar vertebra, he finally made a major discovery.
Two peanut-sized intraspinal tumors were found in the spinal canal of the second and third lumbar vertebrae.
This made Yu Zhiming finally breathe a sigh of relief.
Proving once again that he is a medical genius and is not troubled by a little constipation!
"What? I have a spinal canal tumor? Is my constipation these past few months caused by spinal canal tumors?"
The woman looked shocked and a little unbelievable.
Yu Zhiming explained: "Tumors in the spinal canal cause spinal cord damage, which may affect the nerves that control intestinal peristalsis."
"This will cause intestinal peristalsis to slow down, intestinal emptying will slow down, and it will lead to constipation."
"It may also affect the nerves that control the abdominal and pelvic muscles, leaving them without enough power to promote defecation."
Yu Zhiming explained and comforted: "From what I've seen, the tumor in your spinal canal is only the size of a peanut, and its edges are quite regular."
"The possibility of complete surgical resection is quite high..."
After sending the somewhat shocked woman out, Yu Zhiming quickly asked the third medical examiner to come in.
He spent too much time on the woman, a full sixteen minutes.
He needs to speed up the progress of the physical examination later.
Fortunately, there were no major problems in the physical examinations of the next twenty-eight people.
Three people had serious cardiovascular and cerebrovascular problems, and Yu Zhiming reminded them to go for examination and treatment.
There is also a 61-year-old man whose stomach also needs a good care and maintenance...
At 5:20 pm, Yu Zhiming completed all his work at Ning'an Hospital.
He moved his wrists, arms, and twisted his waist, stretching his body to relieve fatigue, when Gu Qingran walked into the examination room.
"My cousin Jing's MRI results have come out, and they are exactly the same as what you said."
Gu Qingran sighed softly and said: "Even after seeing the image, she still couldn't believe it."
"She didn't expect that she originally asked you to check for constipation, but she didn't expect that in the end she found an intraspinal tumor."
Yu Zhiming smiled and said frankly: "Fortunately, she asked me to check the cause of constipation first."
"Otherwise, I wouldn't have checked to the end. Maybe I would have missed the intraspinal tumor."
Gu Qingran chuckled and said: "This is because you are very capable. Other doctors may find that the colon is long and not continue the examination."
Yu Zhiming was slightly startled, with a look of displeasure on his face.
"Come to test me again?"
Gu Qingran quickly explained: "Zhi Ming, don't get me wrong, this is definitely not arranged by us."
"It was my cousin Jing's own idea, and she just told me."
"She was examined at a hospital in another city and asked to undergo colon surgery."
"She got scared and ran to Binhai. She didn't believe it was the long colon, so she wanted to confirm it through you."
"I didn't expect you to be extraordinary as soon as you took action and found the final crux."
Yu Zhiming hummed twice.
Gu Qingran laughed again and apologized: "Zhi Ming, in the final analysis, this is because our organization is unfavorable. We did not make it clear to them in advance. We will prevent such things in the future."
"Let everyone in the family talk about it, and don't come to you for a health check with tentative thoughts."
"This way..."
Gu Qingran apologized again: "Don't you want to buy some red wine and white wine? I will give you two boxes each as an apology."
Yu Zhiming refused: "No, this code is the same code, I can't take advantage of you."
"I can understand this so-called test, just don't do it next time."
After a pause, he asked again: "Where are Qing Ning and Zhou Mo?"
Gu Qingran smiled and said: "I have a wound on my face. I'm embarrassed to see people. I've already taken shelter in the car to wait for you..."
When Yu Zhiming walked into the parking lot, he heard cheerful voices coming over.
"Momo, reporting my name to Zhiming really worked, and I actually got a reservation."
"Haha, let's have a big meal tonight."
Yu Zhiming heard Zhou Mo say with a smile: "Judging from the matter of reserving a seat in the restaurant, Dr. Yu's reputation has surpassed that of your brother."
"You can shame him..."
When Yu Zhiming heard their cheerful conversation, all the worries in his heart disappeared.
Still friends...
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