This miracle doctor just wants to be fired!

Emergency room.

In the small lounge next door.

Zhou Cheng sat on the sofa in the lounge, with a laptop on the folding table in front of him.

On the computer screen are all of the patient's previous medical records.

At this moment, Zhou Cheng's brows furrowed into a deep frown.

He began to meticulously analyze the entire course of the patient's condition from the beginning.

The image of the patient's blood oxygen level suddenly dropping was still vivid in his mind.

"When blood oxygen suddenly drops, the first thing to consider is a problem with the respiratory system or the respiratory muscles," Zhou Cheng muttered to himself.

He reviewed the patient's previous chest CT scans and pulmonary function test reports again and again. The patient's respiratory system did have minor abnormalities, but those abnormalities were far from sufficient to cause such a dangerous acute respiratory failure.

"Based on previous examination results, the patient has respiratory problems, but it is very likely not the primary disease."

Zhou Cheng leaned back on the sofa, closed his eyes, and went through the common diseases that can cause respiratory failure in his mind.

Aspiration pneumonia, acute asthma attack, pulmonary embolism, pneumothorax...

Each case was compared with the patient's medical records and examination results, and then eliminated one by one.

Zhou Cheng considered all sorts of common diseases, even some less typical complications, but still couldn't find a diagnosis that perfectly matched the patient's symptoms.

Based on the patient's medical records, it seems that most diseases have been ruled out, leaving only the possibility of some rare diseases.

"What about some rare diseases that can cause respiratory failure?" Zhou Cheng didn't get lost in thought.

He knew that the diagnosis of rare diseases could not be separated from the support of literature, so he immediately began to search for relevant information in authoritative medical databases.

He searched for almost half an hour, only getting up once to go to the toilet.

Fortunately, his efforts paid off, and he actually found a disease with highly similar symptoms: neuronal intranuclear inclusion body disease.

Zhou Cheng immediately opened the relevant documents and carefully studied them word by word.

The literature clearly shows that this disease does indeed cause paroxysmal encephalopathy, and is often accompanied by abnormalities in the nervous system, which perfectly match some of the patient's previous symptoms.

In addition, the patient's electromyography at another hospital indicated polyneuropathy, and all these clues combined gave him a glimmer of hope.

Intranuclear inclusion body disease of neurons cannot be ruled out!

But this joy lasted only a moment before being extinguished by a bucket of cold water.

He suddenly remembered that neuronal intranuclear inclusion body disease has a characteristic "diaper sign" on imaging.

The so-called diaper sign is actually a high signal in the frontal cortex DW sequence on an MRI scan, which is one of the important bases for diagnosing the disease.

However, the patient had already undergone a complete MRI scan at another hospital, and the report clearly stated that no obvious abnormalities were found in the brain images, and there were no signs consistent with the "diaper sign".

The possibility that Zhou Cheng had painstakingly found was once again denied by himself.

He leaned back heavily in his chair and let out a long sigh.

The feeling was like suddenly seeing a ray of light in a pitch-black tunnel.

They ran towards the light with all their might, only to find it was just an illusion when they were about to reach it, and a sense of loss welled up in their hearts as their hope was forcibly extinguished.

However, Zhou Cheng did not give up. His gaze fell on the screen again, and he continued to look through one relevant document after another.

We searched through rare disease databases and case reports from abroad, going through almost every available resource, but still couldn't find another suspicious diagnosis.

However, Zhou Cheng was not too disappointed, after all, the patient had been receiving treatment at another hospital for more than half a year.

I have visited several prestigious top-tier hospitals in China, and the doctors I saw were all experienced specialists.

If he could find the final diagnosis so easily, then he would start to doubt the diagnostic and treatment capabilities of those hospitals.

Just as Zhou Cheng was about to change his approach and re-examine the patient's condition, the emergency call bell in the resuscitation room suddenly rang.

Another new patient has been brought in!

Zhou Cheng immediately composed himself, got up and strode towards the emergency room, temporarily halting the brainstorming in his mind and quickly switching to patient reception mode.

……

The patient was brought in accompanied by a caregiver from a nursing home in the city.

When the gurney was wheeled into the emergency room, the patient was curled up, clutching his abdomen tightly with both hands, his face showing pain, and he occasionally let out a weak groan.

Zhou Cheng quickly stepped forward, checking the patient's condition while asking the caregiver about the illness.

The caregiver spoke rapidly, "Doctor, he's about sixty years old, has an intellectual disability, and doesn't speak very clearly."

"We've been cooking jujube porridge for him these past few days, but he eats very quickly and never chews his food properly before swallowing. About a week ago, he started complaining of bloating and stopped having bowel movements."

"We rushed him to the hospital and had an abdominal CT scan. They found more than 10 date pits in his stomach and small intestine. We went to three different hospitals, but the doctors in the gastroenterology endoscopy department and the general surgery department were all reluctant to admit him. Finally, someone recommended that we try your hospital's emergency department."

Zhou Cheng took the abdominal CT report from the caregiver and quickly browsed through it. His brows furrowed even more as his gaze fell on the images.

The CT scan clearly showed that there were more than a dozen date pits scattered in the patient's stomach and small intestine. Some were embedded in the stomach wall, some went down the intestines, and a few were stuck in the narrow part of the small intestine.

The surrounding intestinal tract has shown slight dilation and edema.

He instantly understood why doctors from other hospitals dared not admit him.

Digestive endoscopes can only reach the lower part of the stomach and duodenum, and cannot reach the date pit deep in the small intestine, so the date pit cannot be removed through endoscopy.

However, if surgery is performed to remove all the date pits, it would be necessary to cut open multiple sections of the intestine.

If too much of the intestine is removed, it can lead to short bowel syndrome, which can severely affect the patient's digestion and absorption, and may even require lifelong nutritional support, posing a significant risk.

What troubled him even more was that the caregiver said the patient had no known family members and had always lived in a nursing home.

But having worked in the emergency department for so many years, he was all too aware of the potential dangers of this situation.

Although patients don't have many family members showing up now, if any accident happens to a patient in the hospital, or even if the condition itself progresses, a large group of so-called "family members" may suddenly appear, causing endless harassment and even making unreasonable demands, which will bring more trouble to the diagnosis and treatment work.

Zhou Cheng took a deep breath, suppressing his concerns, and turned his gaze back to the patient.

Let's proceed with the treatment step by step, starting with a physical examination.

He first gently pressed on the patient's abdomen, asking about the location and severity of the pain.

However, Zhou Cheng was already rapidly calculating the best treatment plan in his mind.

The goal is to remove the date pit as quickly as possible to alleviate the patient's pain, minimize surgical risks, and prepare for any unforeseen circumstances.