Chapter 712: Chapter 292: Dare to take a step and see, Director Zhang’s call for help
“Can Dr. Zhou share the basis of the diagnosis?”
Yang Chan still felt somewhat incredulous.
The symptoms of this patient clearly indicated rectal cancer, and the experts had previously discussed and concluded that the patient might have gastrointestinal cancer. She could accept all these judgments and views.
Because one of the biggest characteristics of digestive tract tumors is that they tend to metastasize downwards.
For example, esophageal cancer, if not discovered in time, is very likely to metastasize, and patients may develop stomach cancer, intestinal cancer, and so on.
The ovaries are not part of the digestive system and are located in the pelvis of females, roughly behind the iliac anterior superior spine.
Although they are adjacent to the rectum, the pathology of the two doesn’t quite fit together.
Even if the patient’s primary lesion is an ovarian tumor, the uterus is the most likely to be affected by metastasis.
“Well… the diagnostic basis of this case mainly combines signs and clinical experience! Inspection data only played an auxiliary role in diagnosis. For example, the patient has been experiencing abdominal distension for nearly five months, and there are symptoms such as difficulty defecating and ascites. These conditions all hint at disease in one or multiple organs.”
“Abdominal distension, difficulty in defecation, after first excluding the possibility of colorectal lesions, I used clinical experience to reason in both directions. Rectal tumors can cause difficulty in defecation and can also lead to abdominal distension. However, when I found out that the examination of the ascites fluid revealed signet ring cells, I immediately suspected that not only the rectum was affected, but the stomach likely also had lesions.”
“After conducting examinations, a tumor was confirmed on the greater curvature of the stomach. If we follow the conventional diagnostic thinking, stomach cancer metastasizing to the rectum and causing rectal cancer, this thought process is plausible. But if one is more careful, they would notice that the volume of the rectal tumor is quite large, while the tumor on the greater curvature of the stomach is relatively small. Moreover, the patient only started experiencing stomach discomfort in the past one or two months. I boldly determined that the stomach tumor occurred later than the rectum.”
Zhou Can analyzed for her in detail the diagnostic thought process.
Listening to this, other experts all nodded in agreement.
Yang Chan’s gaze towards him also sparkled with admiration.
She had actually never thought of using reverse inference for diagnosis.
“It is quite common for stomach cancer to metastasize to the rectum, but it is relatively rare for rectal cancer to metastasize to the stomach. Therefore, I determined that the stomach tumor is still not the primary lesion. As for why I suspect an ovarian tumor, it is based on my personal clinical experience and some vague pathological evidence. The risk of ovarian changes in females over 40 greatly increases, and just so happened that I have diagnosed three cases of ovarian cancer metastasis. This is how I made this bold determination.”
Zhou Can continued to explain his diagnostic basis.
Not only the experts and Yang Chan at the scene but also the family members nodded repeatedly in agreement.
“Teacher, do you think an abdominal and pelvic CT scan and tomography can detect the ovarian tumor?” Yang Chan now had no doubts about Zhou Can’s diagnostic approach, but she still had reservations about the diagnostic result.
“Ovaries are gonadal organs, and diagnosing their tumors is even more difficult than diagnosing pancreatic cancer. CT scans have a certain probability of finding lesions, but it is also possible that the lesions won’t be prominent. Not to mention CT, even MRI has the possibility of missed diagnosis and misdiagnosis. Taking suspected tissue for pathological examination is the gold standard for confirming this disease. Dr. Zhou is right; we could obtain some tissue through surgery for a pathological biopsy.”
Zhang Bihua, with such abundant diagnostic experience, said that regular examinations are hard to diagnose.
This is enough to show how difficult it is to detect ovarian cancer.
After communicating with the patient and her family, they agreed to have surgery to remove some tissue for biopsy.
There is no need for the experts from Tu Ya to perform the operation personally; Xinxiang Women and Children’s Hospital’s operating room is fully capable of the surgery.
If the hospital did not have this surgical capability, it would not be possible for it to become a strong tertiary specialized hospital.
Zhou Can’s repeated outstanding performance caused his status in the eyes of the experts to soar. Those who were unfamiliar with him previously began to admire him upon closer inspection.
Xinxiang Women and Children’s Hospital has also started to focus on this capable resident doctor with notable strength.
Journalists also realized that this young doctor was extraordinary, much more so than the returned Ph.D. They began to watch Zhou Can with or without intent.
Mu Qin was the first journalist to recognize that Zhou Can was a big fish.
At this moment, she was distressed about how to quickly establish a good relationship with Zhou Can, to get him to accept her interview.
Regrettably, her beauty and coquettish tactics, which never failed with other men, seemed to have no effect on Zhou Can.
This caused her much annoyance.
Zhou Can did not pay any mind to the admiring or reverent gazes. After helping diagnose this patient, he returned to the resuscitation room.
The pregnant woman, carrying a five-month-old child, deeply touched his heart.
After stabilizing the patient’s vital signs, the first six hours were crucial.
“Dr. Pang, there’s nothing abnormal about her condition, right?”
Zhou Can asked politely.
He was not familiar with Dr. Pang, so he naturally couldn’t converse with her with the same ease as with Deputy Director Shi.
“It’s okay!”
Dr. Pang’s tone was a bit cold, and there was not much smile on her face.
Zhou Can had already noticed that her mood was a bit off.
For example, this morning in the emergency treatment of the pregnant woman, she was also a member of the crisis management team and should have followed Zhou Can to assist, but she didn’t. During the emergency, she did her own thing, without the slightest intention to prioritize Zhou Can.