Seeing Gu Weimian''s appearance, Wu Mian was startled.


    "Director Gu, you have insomnia and have a bad rest recently?" Wu Mian asked, "Why are your eyes so dark."


    Gu Weimian thought you didn''t do it? But in his heart, he can have any stomach Fei. He doesn''t dare to harden Wu Mian. You can''t do or not do such a thing as death.


    "Miss Wu, you came here on time." Gu Weimian forced out a smile.


    "Oh, I have to pick up the plane later. There are still two and a half hours." Wu Mian said, "I don''t know if I can."


    Two and a half hours, a gastroscope? Gu Weimian looked at him suspiciously. He didn''t know what teacher Wu meant.


    After hesitating for a while, Gu Weimian didn''t decide to say anything directly until he changed his shoes.


    He asked, "Mr. Wu, you don''t doubt it''s not esophageal cancer."


    "Maybe not." Wu Mian said, "I told you yesterday. The density is wrong."


    "Density?"


    "In fact, it''s better to have a 64 row CT film to see more clearly. But to do 64 row CT, it''s better to do gastroscope directly to see more clearly." Wu Mian said, "have you handled esophageal stones here?"


    "...." Gu Weimian said nothing. Wu Mian considered esophageal calculi? It''s impossible! Stomach stones have been seen, esophagus straight up and down, and the probability of stones is ridiculously small.


    "Director Gu, if you haven''t been in touch, you can send someone and a girl. She has a template." Wu Mian said.


    Chu Zhixi smiled and Gu Weimian looked confused.


    Arrange someone to take Chu Zhixi to do the writing work. Gu Weimian carefully recalls what Wu Mian just said. He thinks it''s impossible!


    That''s not rigorous. It''s not impossible, but the possibility is very low.


    Why is the probability extremely low?


    Digestive tract stones generally stay in the stomach, and they occur in the esophagus, which is very rare, and the probability is very small.


    Gastrolithiasis refers to the pathological changes caused by the undigested and long-term coagulation of ingested hair, plant fibers, such as persimmon or black dates and minerals in the stomach.


    It can be divided into hair stones, plant stones and mixed stones.


    The formation of digestive tract stones such as persimmon stone is mostly in the environment of pH4. Under normal circumstances, the pH value of esophagus is about 6, which is not easy to form primary gastrointestinal stones.


    Even if hair is ingested by mistake, it is in the esophagus... It is a pipe that hardly stays, and there is no condition for stone formation.


    Gu Weimian recalled carefully and determined that his idea was right. At least I have been doing chest surgery for more than 20 years and have never seen a similar patient.


    Although he thinks so, Gu Weimian is a little uneasy. I used to think that there were enough checks, but now I''m a little worse.


    A barium film of the upper gastrointestinal tract is not enough. In addition, although the lung CT carries the esophagus, the imaging department will expose the lung, not all the organs.


    "Director Gu? Are you a little tired? I don''t think you are in a state." Wu Mian asked when he saw that director Gu was distracted again.


    Gu Weimian smiled, "Miss Wu, I''m sorry. I didn''t sleep well yesterday."


    "I''m sorry," said Wu Mian with a smile. "If I disturb your rest in the middle of the night, you should bear more."


    "Mr. Wu, you''re very kind. To tell you the truth, I haven''t seen esophageal calculi. What are the imaging features? Mr. Wu, you''re sure it''s esophageal calculi. Is there any secret?" Gu Weimian decided to ask first.


    Like that time on laogua mountain, I really didn''t see the problem and thought the patient was hysteria. Anyone who thought of a few calcifications turned over the boat. Until now, he was embarrassed to go to laogua mountain to see Taoist Lin.


    "What you and your colleagues in the imaging department have analyzed is right. The oval filling defect shadow has no obvious damage to the mucosa. It can be judged to be an esophageal tumor," Wu Mian said.


    "...." Gu Weimian was stunned. He knew that there was a turn in God, but he couldn''t speak.


    Put your ears up and Gu Weimian listened quietly.


    "But from another point of view, the esophageal stone shadow is similar to the gastrolith, and also presents an oval filling defect shadow with smooth surface and longitudinal running, without obvious damage to the mucosa.


    Due to the limitation of the esophagus and not moving like the stomach persimmon stone, it is difficult to see the typical "snowball sign" and "bird''s nest sign", and there are no obvious morphological changes like esophageal cysts. "


    "Because there is only one lung CT available for reference, I guess - the first esophageal barium swallow examination shows linear stenosis in the cardiac area. If there is no esophageal space occupying lesion, we can consider cardiac achalasia. The patient has cardiac achalasia and gastric juice reflux, resulting in the reduction of pH value in the esophagus and creating strong conditions for the generation of esophageal stones."


    Gu Weimian tried to recall the imaging data of barium radiography of the upper gastrointestinal tract. It seems that he and other directors did ignore the linear stenosis of the cardiac area.


    But the patient has esophageal cancer. Who cares if there is cardiac achalasia?


    In the operation of esophageal cancer, the tumor is cut off, part of the stomach is cut off, and the remaining stomach is pulled up to replace the esophagus. There is a linear stenosis in the cardiac area. There must be no problem after the operation, because this piece has been cut off and sent for pathology.


    This is a blind area. All attention is focused on the tumor and tumor related information, and the linear stenosis of the cardiac area is completely ignored.


    But even so, esophageal stones are just a guess. Gu Weimian suspiciously led Wu Mian into the endoscopy room. The patient was already lying in bed waiting for examination.


    "Director Gu, you''re here." the doctor who did the examination said hello, but from the corner of his eye, he saw Gu Weimian bending down and leading a tall young doctor into the room.


    The contrast between old and young, short and tall, humble and approachable was strong. The doctor in the endoscopy room was stunned and immediately realized who this was.


    "Wu... Miss Wu?!"


    "Well, hello." Wu Mian smiled and nodded, "do it, I''ll look at it first."


    "Miss Wu, why do you have time today?" asked the doctor in the endoscopy room.


    "My friend asked me to help you see the situation. Your name is sui Liang. Deng Ming asked me to take a look for you." Wu Mian said gently to the patient, "don''t worry about small problems."


    "You are..."


    "I''m a doctor from the imperial Union Medical College Hospital." Wu Mian didn''t mention his name. He was young. In the eyes of patients, it was a disadvantage. He said that Wu Mian didn''t know. He thought there was something wrong with the little doctor and directly signed up for the number.


    The hospital is better than your name.


    "Thank you, thank you." Sui Liang''s expression was a little depressed. He thanked insincerely.


    Had a tumor, although the doctor said it had not metastasized, Sui Liang also knew that at this time, the doctor might tell the truth to his family, but it was absolutely impossible to tell the truth to himself.


    Good news without bad news, that''s about it.