CT and gastroscopy negated all the speculations just now. Now that the more than ten doctors were staring at each other, they were stunned.

When he returned to the ward, Dad Qiu still had severe abdominal pain, and his symptoms became more and more serious. He was lying on the bed and humming, so anxious that his mother Qiu kept questioning in the local dialect.

"I said, are you foreign doctors good? Why didn't you even know any disease after checking for a long time?"

Qiu Yuxing didn't know if it was intentional or was really anxious, so he grabbed Chen Xia's hand: "Xiaoxia, please, please save my dad."

Chen Chun and the many young doctors next to him looked at each other differently. He was tugging with his female classmates in the public hall?

If Gu Lin was on the scene, she would have to beat the dog and the woman to death with one palm.

Chen Xia was also very embarrassed. When she pretended to go through the medical records, she shook her hand away, thinking that even if you want to eat my tofu, you have to take advantage of the time when there is no one at night. There are so many people watching, and the time is wrong.

Dr. Barry Marshall didn't have so many inner thoughts, but kept thinking with his chin on his back.

"No, no, no, there must be details we overlooked here. Dr. Chen, please help me ask if the patient has any underlying diseases before?"

After listening to it, Mama Qiu thought for a long time, "Two years ago, my husband found that his blood sugar was high during a physical examination at the unit. The doctor was considering diabetes at that time. Later, the re-examination was normal again and so we did not continue to treat it. Does this count?"

Chen Xia immediately looked through the medical records. Dad Qiu urgently checked his blood sugar in the emergency room. The results showed that fasting blood sugar was slightly increased, reaching 8mmol/L.

Chen Chun reminded next to him: "Although the complications of diabetes may cause abdominal pain, the mild abnormal blood sugar is really hard to believe."

Dr. Barry Marshall frowned, thinking that it seemed that he would have capsized the first time he came to China to check in. If someone misunderstood that he was a liar, it would be difficult to participate in the experiment in the future.

The group of young doctors next to them were all frowning. All the diseases that could be thought of were eliminated. What should I do?

When Dad Qiu saw more than a dozen doctors surrounding him for a long time, he didn't even know what was wrong, and he became more anxious, so he shouted louder: "Oh, it hurts so much, I'm going to die, help me."

At this time, the laboratory phone call came in time. Huang Xiaoping hurriedly ran over after answering the call: "The results of arterial blood gas analysis come out, indicating that the patient has serious metabolic acidosis."

Is metabolic acidosis a necessary connection with abdominal pain? Is this the culprit behind the scenes?

Dr. Barry Marshall's eyes were like Brother Ikki, and they lit up as soon as they sing.

"By the way, clinically, metabolic acidosis can stimulate the peritoneal nerve plexus, cause abdominal muscle tension, and form pseudoperitonitis. It can also lead to potassium deficiency in the cell, acid-base imbalance, gastric dilation and paralytic intestinal obstruction and causing abdominal pain. In addition, the toxic products of acidosis can directly stimulate the peritoneum and cause abdominal pain."

Chen Chun shook his head and asked a question immediately.

"Dr. Barry, although diabetes is prone to ketoacidosis, the blood sugar of these patients is significantly increased, generally 16.7 to 33.3 mmol/L, or even higher. The blood sugar of this patient is only 8 mmol/L, which is mildly abnormal, which is really hard to believe."

The few young doctors behind him nodded repeatedly and whispered together. Obviously, Dr. Barry Marshall's inference did not convince everyone.

"NO, NO, NO. Diabetic ketoacidosis is indeed the most common acute complication of diabetes. Under the influence of various causes, patients have severe insulin deficiency and inappropriate increase of glucose hormones, which causes sugar, protein, fat, water electrolytes, acid-base balance disorder, and lead to metabolic acidosis."

Dr. Barry Marshall explained, and continued to say to the patient:

"So diabetic ketoacidosis can lead to pancreatic damage and dysfunction, leading to increased amylase. Therefore, the common clinical thing you are diabetic ketoacidosis caused by hyperglycemia, but some patients with ketoacidosis have low blood sugar, or even normal or low blood sugar."

Chen Chun widened his eyes: "You mean, diabetic ketoacidosis caused by non-hyperglycemia?"

"Yes, this probability is very small, but it cannot be ruled out."

Just as everyone was arguing, the laboratory had sent someone to deliver a report: the blood ketone body was significantly increased, reaching 5mmol/L, the urine ketone and urine sugar were positive, and the glycated hemoglobin also increased significantly.

The diagnosis of metabolic acidosis has been clear.

In the 1980s, the living standards of ordinary people were not high, and after all, there were only a few who could go to doctors to see a doctor. Moreover, due to the lack of examination equipment and the problem of doctors' level, people rarely think of ketoacidosis.

Especially the abdominal pain caused by ketoacidosis is a problem that everyone could never imagine. So this round opened everyone's eyes and several young doctors were trying hard to take notes.

Let everyone remember a knowledge point. In the future, patients with diabetes should check their blood, especially those with diabetic abdominal pain.

But Chen Xia still had different opinions, "Dr. Barry, I think the diagnosis of pancreatitis cannot be ruled out,"

Dr. Barry Marshall was a little proud just now, feeling that he had diagnosed a difficult and complicated disease. Obviously, the little doctors around him looked at him with a little bit of admiration. Now Chen Xia suddenly jumped out, and he felt a little uncomfortable.

"Doctor Chen, the CT scan just now showed that there was no oozing around the pancreas, so how could it be diagnosed as pancreatitis?"

Chen Xia is not the little doctor next to him. He is still confident in his diagnosis level and does not blindly follow him, so he explained:

"I can prove from several points that 1. The patient's abdominal pain is located at the pancreas. 2. The increase in blood amylase is 5 times higher than normal, combined with the patient's heavy drinking and a history of high blood sugar, leading to blood concentration.

3. There are relatively high imaging manifestations 12-24 hours after the onset of pancreatitis, and the most obvious occurrence is 24-48, so CT does not show any pancreatic problems, and the time may not be up.

4. If it is caused by ketosis, there is a typical characteristic: the symptoms and signs do not match, that is, the symptoms of abdominal pain are severe, but the signs are mild, and there is mostly no obvious tenderness or rebound pain. Similar to ureteral stones, the symptoms and signs do not match.

And the patient has signs of peritonitis, which I think is more supportive of the diagnosis of pancreatitis.”

After Chen Xia finished speaking some points, Dr. Barry Marshall kept pondering, but because many of Chen Xia's arguments came from later views, he was a little confused because from his clinical experience, he felt that Chen Xia was right.

The little doctors next to them looked at their idol in admiration, and looked at Chen Laoshi. They were not at a disadvantage when facing foreign doctors. It was indeed amazing.
Chapter completed!