After a scolding, the meeting room became quiet.


    Zhuang Yongzhi and Zheng Qingmu looked at each other, and they really felt the momentum of Dr. Wu.


    Although swearing is vulgar, Dr. Wu has his own reason. And he was very strong. Just because President sun refused to listen to Dr. Wei''s report, Wu Mian did not hesitate to turn his face directly.


    "I can imagine that you make rounds every day, look at patients, sit in the office and look at various examination results and pathological descriptions. In that case, what''s the use of you?!" Wu Mian''s fingers beat the table faster, and the sound was like a war drum.


    "Nurses write nursing records, which are written by nurses. People''s cognition is different. Why don''t you go and have a look in person?"


    President sun didn''t know why Wu Mian knew that no one had seen the patient''s stool, but what he said was the truth. President sun was interested and didn''t dare to refute. He had to bow his head and listen and scold in his heart.


    "Dr. Wei, go on," said Wu Mian.


    Trinket stared at the back of section chief Wu. Although he knew he was supporting himself, he... Scolded fiercely now. He would tell his own judgment later. When he was hurt by others, he would lose face even more.


    Silence, silence in the conference room.


    Chu Zhixi broke the embarrassment with a smile, "Dr. Wei, you dare to say that it''s okay. There''s a brother here. What you see has basically determined the condition."


    "Er..." Wei Dabao was stunned. Did section chief Wu think the same as himself?


    "Report the medical history." Wu Mian knocked on the table with his fingers, and the thumping sound pulled back Wei Dabao''s thoughts.


    "Yes, section chief Wu." Wei Dabao said respectfully, "I found a problem. I haven''t seen the previous medical record. I''m not sure. The patient had diarrhea yesterday morning, and the defecation volume was about 2000ml, but it got better in the afternoon."


    "Yesterday''s treatment was under the pig tail... Ureteral stent, and some drugs were replaced."


    Chu Zhixi then flipped the tablet in front of him and said, "the ureteral stent was placed three times, and yesterday was the last time. After each time, the diarrhea improved."


    "That''s because every time we need to remove the ureteral stent, we invite the world''s top experts to consult and modify the drugs for diarrhea," said President sun.


    "Dr. Wei, continue." Wu Mian said in a deep voice.


    "I observed the patient''s defecation and found that although the stool was formed, there was still about 200ml of watery stool." Wei Dabao said his greatest harvest when observing the stool, "this is difficult to explain."


    Then Wei Dabao looked at Wu Mian.


    "The treatment in Yanghe hospital was initially suspected to be infection, and the replacement of several antibiotics did not work. Later, after consultation, I found a rheumatic immune expert to see that it was suspected to be systemic lupus erythematosus and gave hormone shock treatment." Wu Mian seemed to see the eyes of Wei Dabao and began to describe the treatment process.


    He didn''t look at the tablet in front of him. Dean sun and other doctors looked at Wu Mian in surprise. They didn''t know how this one knew so much. He did turn the tablet a few times just now, but what''s enough?!


    "After each ureteral stent, the urine volume becomes more, the renal failure is relieved, and the amount of diarrhea is reduced. But about 3 days is the limit, and then there will be an aggravation of diarrhea." Wu Mian ignored the eyes of others. He looked ahead and said faintly, "Dr. Wei, continue to say your judgment."


    Wei Dabao was confident that he could feel the encouragement of section chief Wu.


    "I suspect that the patient''s ureter is connected to the intestinal tract," said Wei Dabao


    "Boom ~ ~ ~" there was a sudden uproar in the conference room.


    "It''s impossible!" a foreign doctor stood up and shouted.


    "Radiation injury leads to long-term inflammatory stimulation and ureteral and small intestinal fistula. Although it is rare, it is not impossible." Wu Mian smiled at the man and said, "what evidence do you have that this speculation is impossible?"


    "The position of radiotherapy is in the pelvis!"


    "This is not a reason," said Wu Mian. "You, sit down. If you want to speak, raise your hand first. How did your teacher teach you? Your superior doctor will allow you to be so impolite?"


    The man was stunned and murmured, "I''m a superior doctor."


    "It''s not now. Sit down," said Wu Mian. "Dr. Wei has just put forward his consideration. The preliminary diagnosis is ureteral intestinal fistula. I''ll first say why it''s possible, and then we''ll discuss it."


    "Radiation enteritis can be basically determined.


    Secondary colitis and proctitis often occur within 6 ~ 18 months after radiation treatment. The symptoms include diarrhea, bloody stool, mucus stool, acute and severe diarrhea, thinning stool, progressive constipation or abdominal pain, suggesting intestinal stricture.


    Serious lesions form fistula with adjacent organs, such as rectal * * fistula, and feces are discharged from * *; rectal and small intestinal fistula can cause chyme mixed with feces, or peritonitis, abdominal or pelvic abscess due to intestinal perforation. "


    "There is little possibility of sinus in ureter and intestine, but this can not be ruled out according to the periodic change of the amount of diarrhea."


    "I believe everyone has noticed one thing recorded in the medical record." Wu Mian resumed his gentle attitude, and Lang Lang said, "after each ureteral stent, the patient''s diarrhea will improve.


    Although different doctors consult and formulate treatment plans, it is inevitable to lower the ureteral stent each time, and then change the drugs. We can say that it is the effect of drugs, but the urination is unobstructed and the amount of diarrhea is reduced. This obvious change can not be ignored. "


    "If according to President sun, it is the effect of drugs, there is no way to explain the subsequent changes in the condition. After each ureteral stent, the urine volume decreases within 2-3 days and the diarrhea increases."


    "Please note that the patient has 5000 ml of diarrhea every day. I can''t think that other diseases can lead to such serious consequences except cholera."


    "With such a large number of diarrhea, the changes of serum ions in patients are not cliff like. I don''t know if all of you here have treated cholera patients. I have relevant experience." Wu Mian said with assurance, "the changes of serum ions after a large number of diarrhea are quite large, but the test results of patients deny this."


    "Such obvious evidence was ignored by everyone." Wu Mian said and shook his head.


    "Again, there were three consecutive records of forming feces... Two times, the third time just observed by Dr. Wei." Wu Mian corrected his statement, "they all appeared after the ureteral stent was removed, so we can''t rule out the possibility of ureteral intestinal fistula."


    "These days, the nursing home and hospital have ruled out many causes. Although it is hard to believe, in the end, there is only one diagnosis! Even if it is rare."