Chapter 321 [321] Palpation

   The patient's plea is moving.

  Xie Wanying thinks about it: Doctors will be very embarrassed in such a situation.

   Look out of the corner of your eyes to see what Teacher Tan will decide.

   She looked over at the teacher, and seemed to accidentally bump into the corner of the teacher's eyelids.

   Teacher's look made her suddenly feel a little guilty in her heart.

   "Lie down on the examination bed." Tan Kelin put his fingers back on the medical record page and said to the patient.

   Following the order, Xie Wanying opened the white curtain beside the examination bed.

  The two sons helped the old lady to lie down on the examination bed.

   "You check her first." Tan Kelin ordered the students.

   After receiving the teacher's instructions, Xie Wanying turned around and came to the examination bed, took out the stethoscope in her pocket, and placed it on the patient's heart, lungs and abdomen to listen. After listening, put on gloves for palpation.

  Because the patient has done related examinations in other hospitals, he mainly touches the diseased part to save time.

  The superficial part is first palpated, the right hand is held together and flat, and the affected side of the patient is gently touched with the finger pulp. Here is the left colon region. Due to the narrow intestinal lumen of the left colon, acute and chronic intestinal obstruction is likely to occur in the occurrence of tumors, which is in line with the characteristics of this elderly patient.

   Elderly patients, when they were young, they could not eat in times of famine. When they are old, their economy is better, their children are filial, and they eat a lot more fat than before. The old man didn't keep his mouth shut, and the child didn't study medicine and didn't understand. He just thought that feeding the old man a lot was filial piety, but he didn't know that high fat was one of the main risk factors for left colon cancer.

   When he found out that the more he ate, he became thinner, had difficulty in defecation, and even vomited, then he knew something was wrong, and he rushed to the hospital. A check, the middle and late stages.

   This kind of thing is common in clinical practice, and family members have done bad things with good intentions. It shows that the national health education is completely incompatible with the growing economic and living conditions.

  Xie Wanying's fingertips searched for the mass in the patient's abdominal cavity.

  This tumor is not small in the CT photos taken in other hospitals, but the left colon tumor itself is difficult to touch. The old lady is thin but the abdomen is not thin and bulges when she is flat. It is not easy to feel the deep tumor in this patient's body.

  The superficial palpation cannot be changed to the deep palpation. The two, three, and four fingers of the right hand are put together, and the end is pressed down deep into the patient's abdomen. Finally, a lump can be felt, which is very deep. Gently slide your fingers left and right up and down the mass to feel the situation around the mass.

The    position is too deep. Xie Wanying thought: No wonder the patient was misdiagnosed in a small hospital near his home a few times when he sought a doctor. The doctor thought it was just a common gastrointestinal problem and did not ask the patient to continue the examination. The patient even vomited, and the emergency doctor in the second-class hospital once thought it was gastritis. It wasn't until it became intestinal obstruction that I realized that it was a big problem and transferred to a top-three hospital.

   Speaking of this, the patient's two sons reluctantly said: "I don't know how the doctor looked at the disease before. I should have known that it was a tumor and immediately asked someone to cut it. The result was missed by more than half a year."

  It is half a year old, and early stage tumors and middle and late stage tumors cannot be generalized at all.

  Because of this experience and word of mouth, the common people now all like to run to the top three.

  Some diseases are easily misdiagnosed in clinic, like the old lady. The doctor asked the patient to check too much, and he had to be scolded by the patient. Like this kind of elderly patient who has a little stomach pain and vomiting and calls for a gastroenteroscopy, the old lady thinks that it is terrible to insert the tube into the mouth and anus.

   The common people do not understand it and think that the doctor is not good enough. In fact, the doctor has already said that instead of waiting for the treatment to be cured, it is better to go for a regular physical examination. Any disease can be detected early for you. Early investigation and early treatment, everyone is happy.

   (end of this chapter)

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