Tumors were not painful or itchy. Who would go to the hospital and spend a few thousand yuan just for a check-up when they did not even feel that sick?
Many patients with hepatitis-B were not meticulous with their examination and treatment.
Zheng Ren left the ward. He was not in a hurry to go to the office. Instead, he began to ponder.
He felt that his attitude toward patients had changed recently. Had he become more positive? Or was he turning into someone who was more soft-hearted?
Li Chen could be taken as an example. Previously, all Zheng Ren would care about was the fact that he needed surgery. He would do his best by personally performing the 64-slice CT scan with 3D-image reconstruction.
This morning however, he had actually explained his condition to him for more than ten minutes.
What was going on?
Zheng Ren thought about it for a long time but still could not figure it out.
While pondering, the professor's voice came from behind him. "Boss, good morning... Yawn."
While speaking, the professor yawned loudly.
"Morning, Lil Fugui."
"Boss, I'm going to remove the patient's urinary catheter today. Do you think it's okay?" Professor Rudolf Wagner asked.
The professor could make the decision on his own but out of respect for Zheng Ren, the professor still reported to Zheng Ren over and over again, letting him make the decision instead.
..
..
Author's note:
One of my patients joked that if I wrote a book, you'd probably be in it. He himself smiled and said 'alright' toward it. The names in this chapter are all from real people. It's been three years now and nothing has happened to them since then. It'll be good if it keeps this way.
Chapter 508 - There’s a Balloon In Their Stomach?
"I should be able to give it a try." Zheng Ren was quite confident that the surgery would be a success.
"Alright, I'll go and remove the catheter now." Professor Rudolf Wagner became cheerful. "Boss, if everything goes well, I'm prepared to return to Heidelberg soon and perform dozens of similar surgeries."
"Okay."
"If there are any problems, can you fly to Heidelberg?" the professor asked nervously.
"You want me to fly there..." Zheng Ren hesitated. Heidelberg was so far away.
"Boss, please!" Professor Rudolf Wagner's eyes sparkled as he pleaded with him. "I'm working hard for our scientific research."
"Unless it's necessary, I'll fly there. Under normal circ.u.mstances, we better keep it all to online consultations." Zheng Ren did not directly refuse, leaving the professor with a glimmer of hope.
The professor probably understood what Zheng Ren was thinking.
When he heard Zheng Ren's words, Professor Rudolf Wagner suddenly jumped up. "That's great. You're doing the work of an angel. In fact, you're one yourself."
"Don't talk nonsense. Hurry up and get to work." Zheng Ren waved his hand and chased the professor away.
Zheng Ren glanced at the office. Seeing that there was nothing else, he went to the ICU to see the two patients after their surgery.
Su Yun was very energetic, one would not be able to tell he had not slept last night at all.
Seeing him like this, Zheng Ren was relieved.
This meant that the patient's condition was stable.
"Boss, why did you come over so late?" Su Yun blew at his fringe resting on his forehead.
"I met a patient with a terminal tumor and was going through the surgery procedures. I was giving him some extra advice on his situation," Zheng Ren said. "How's the situation?"
"We can proceed with extubation. Since I was the one looking over the patient, we can remove the tubes now," Su Yun said with a smile. He was clearly very happy.
"Oh?" Zheng Ren glanced at the teenager who had been penetrated by the steel rebar and removed the suction machine. His face was pale. He lay on the hospital bed and looked around, his eyes wide open and filled with fear.
Du Chunfang also removed the suction machine, intubation tube, and oxygen machine. The patient's blood oxygen saturation on the monitor was maintained at about 95%.
The effects were immediate. Zheng Ren smiled. He thought that Du Chunfang would have to wait another day. He did not expect that under Su Yun's care, the ventilator would be able to be removed 12 hours after the operation.
This was amazing!
Zheng Ren only took a look at the vital signs from afar and used the System's panel to check. He did not stand by the patient's bedside and mention anything further.
This was because it was not necessary. The patient had already removed the tube and ventilator. This proved that the patient's condition was stable. What else was there to talk about?
Furthermore, this was not the emergency ward; it was the ICU. He was not Su Yun either. If he kicked up a fuss here, the more he would rake in Chief Qian's ire. Perhaps Chief Qian would not react, but it was best to avoid such a situation.
Zheng Ren was just about to ask Su Yun if he wanted to leave with him when his cellphone rang.
He took out his cellphone and saw that it was a call from the emergency department. Zheng Ren's heart rate suddenly soared.
"Hello, this is Zheng Ren.
"Huh? What did you find?
"Okay, I'll go down and take a look."
After he finished speaking, Zheng Ren hung up the phone and turned around to leave.
"Boss, what's wrong?" Su Yun was curious and chased up to him to ask.
"The emergency department has received a 70-year-old old man. A huge bubble can be seen above the pubic symphysis. The physician said that it's like a balloon in the abdominal cavity. I've never heard or seen something like that before," Zheng Ren said.
Su Yun thought of something else. "Could he have been fooling around too much?"
"It can't be. He's already 70 years old. He couldn't have been doing such things," Zheng Ren said. "Go take a look. I have a feeling he might need surgery."
It was just a hunch, so there was no use in pondering too much about it.Find authorized novels in , faster updates, better experience, Please click #'s-studio_16489637605120805/there%E2%80%99s-a-balloon-in-their-stomach_50340009059876829 for visiting.
The two of them were silent. They rushed all the way to the emergency department.
There was always a steady stream of patients in the emergency department even in the morning. An old man sat on a bed in the emergency department. He seemed hale and hearty, his face flushed a bright red.
"Chief Zheng, come and take a look." When the doctor from the emergency department saw that Zheng Ren had rushed over, he immediately redirected him to the patient in front of him. After that, he took an X-ray scan and inserted it into the reading device.
On the X-ray scan above the pubic symphysis, there was indeed an eight by six cm image. There was a black shadow inside his cavity that looked just like a balloon.
"The patient complained that there was no obvious cause for lower abdominal pain a day ago. It was tolerable. There was frequent urination, no fever, no nausea or vomiting, and normal bowel movements. There was just slight abdominal distension," the emergency physician briefed them on the patient's condition.
"I had him take a physical examination. I wanted to check if it was an intestinal obstruction, so I opened up the c.h.e.s.t and abdominal connection. The radiologist called and asked me to open up a plain film. He said that there was something wrong with the examination."
That sounded about right. After seeing such an image, the radiologist would definitely have asked the emergency department doctor to leave behind the image data.
"Later, I did a plain scan of the patient's abdomen. The CT room's opinion was that there was an abscess around the colon."
Although Zheng Ren had learned about the patient's diagnosis through the System's panel on the upper
right side of his vision, he still refused to believe it even though he had a reasonable level of trust in the System's diagnosis.
After carefully looking at the scan, Zheng Ren began to hesitate.
Since there were plenty of patients in the emergency department, he could not stay there for too long. Therefore, Zheng Ren took the scan and brought the patient and the family members straight to the emergency ward.
The patient's family was a little worried. During the consultation process, they changed doctors and went through many tests one after another. They had a bad feeling about it.
One of the family members fell behind and kept making calls.
Sea City was not a big place. With three to five people and a wide network of connections, one would know most people in the city.
When he arrived at the emergency ward, Zheng Ren went straight into the office. He inserted the abdominal plain film and CT film into the reading device, resting his chin on his hand as he carefully analysed the situation.
"Doctor, is everything okay?" a female family member of the patient asked worriedly.
"There's a small problem but it's not too serious," Zheng Ren said.
Although that was what he had said, the uncertainty contained in his words could not calm the anxious mood of the patient's family.
"Boss, it should be an abscess. Let the ultrasound guide the puncture and drainage," Su Yun said after looking at the scan for a while.
Zheng Ren shook his head slightly. He had already denied the possibility of an abscess. His judgment of the condition was similar to the System's own diagnosis. It was most probably a a huge colonic diverticulum.
However, there were some difficulties in making such a diagnosis. Zheng Ren was thinking about how to differentiate and diagnose it from his own knowledge and experience.
"Little Zheng, are you looking at the scan?" Chief Xia asked as she walked into the office, also deep in thought.
"Hello, Chief Xia. I'm Brother Liu's friend. The patient is my father," the man who had fallen behind to hurriedly make a few phone calls walked forward and said politely.
"Yes, everything should be fine as long as Chief Zheng is here. Regardless, let me take a look. I can't really see the problem from where I'm standing," Chief Xia said bluntly.
The family members of the patient thought that Chief Xia wanted a red packet so they simply agreed out of habit. No one believed that Chief Zheng was the main doctor.
It was obvious at a glance who had more experience between the young and old doctor.
Walking to the screen reader, Chief Xia took a look at the film and her interest became piqued.
"Chief Xia, you can help give me your inference on the patient's diagnosis," Zheng Ren said.
"Don't say that," Chief Xia said with a smile. "Someone as skilled as you wouldn't need my help for something like this."
Chapter 509 - Boss Peed
Hearing what Chief Xia said, the patient's family also showed a puzzled expression.
It did not seem like he was talking nonsense and was just going through routine procedures. However... He took a look at Zheng Ren again. He was indeed a young doctor.
This was strange.
Many ordinary citizens in Sea City knew about Chief Xia's reputation. She was one of the top experts in the gastroenterology department within Sea City.
How could she hold this young doctor in such high regard?
"Chief Zheng, the amylase in the patient with acute severe pancreatitis has basically returned to normal " Chief Xia mentioned the patient from two days ago to Zheng Ren while looking at the film.
"Well, it's because of your expertise that you were able to treat it well." Zheng Ren gave a standard response. His mind was preoccupied with information about the relevant and differential diagnosis methods that could be used.
"It's all thanks to you." Department Chief Xia did not mind Zheng Ren's reply. With a smile, she asked, "What's your diagnosis of the patient, Chief Zheng?"
"It looks like a large abscess in the abdominal cavity but I don't think that's the case. Right now, I'm leaning more toward colonic diverticulum."
"Diverticulum?" Department Chief Xia was stunned.
"Yes." Zheng Ren picked up the test the patient had done in the emergency department and said, "Chief Xia, look at the patient's blood routine. There aren't any major abnormalities. If there was a large abscess in the abdominal cavity, there should be some relevant changes in the blood test."
Chief Xia gave it some thought.
"Of course, I still have my doubts. The patient is an elderly person, so it's possible that the body wouldn't be able to react to it like it normally would. But if colonic diverticulum was the diagnosis, then the other symptoms could be logically explained." Zheng Ren pointed at the film and using professional imaging terminology, he began to say what was on his mind then for about a full three minutes.
Su Yun's eyebrows furrowed tightly, his head slightly lowered. Through the black hair resting on his forehead, he looked at Zheng Ren's side profile as he spoke with such confidence.
The originally dull face was now brimming with confidence. It was a little ostentatious but not too much.
What had given him such confidence?
Su Yun was a little confused.
This kind of differential diagnosis required skill but more importantly, experience.
In terms of skill, Su Yun did not think that... He did not think that Zheng Ren was that much better than him. However, how could he be so confident?
The same question appeared in Chief Xia's mind.
It was so strange!
"Chief Zheng, I think what you've said just now is because the patient is older. It's more likely that the blood image won't be able to react in a short amount of time." Chief Xia and Su Yun shared the same opinion. It was more likely that it was a large abscess in the abdominal cavity.
Zheng Ren smiled and said, "I haven't seen similar cases in Sea City General Hospital but it has been mentioned in certain articles. The last article published by Doctor Molière's mentioned a similar case, which shares comparisons with the current patient."
Su Yun was suddenly enlightened. It turned out that Zheng Ren had read similar reports before, which was why he was able to confirm the possibility of this being the case.
From the looks of it, the road ahead of him had become much longer.
However, it was strange. He had never seen Zheng Ren read periodicals and magazines. Could it be that he had read them while he was still in school?
Chief Xia still insisted on her own opinion and said, "Similar cases cannot prove..."
"Chief Xia, look here." Zheng Ren's face was filled with confidence. He recalled a case report he had just read. He tried to recall it and suddenly, everything made sense.
Zheng Ren took out a pen and used it to point at a location on the CT scan of the patient's lower abdomen. "Here. The image of the liquid level has changed slightly. The information from the CT scan has been calculated to obtain the x-ray attenuation coefficient or absorption coefficient of each voxel. After that, it's arranged into a digital matrix. The changes here, according to the law of the digital matrix's attenuation and judging by its density..."
Chief Xia was completely confused by the endless technical terms Zheng Ren was using.
Although Chief Xia was famous in Sea City as the Department Chief of the gastroenterology department and had a wealth of clinical experience, it did not mean that she was familiar with CT scans at Zheng Ren's level.
"Boss! Boss peed! The patient has successfully urinated!" Professor Rudolf Wagner's excited voice was like a lion's roar from the other end of the corridor.
"Su Yun, tell Lil Fugui to shut up!" Zheng Ren frowned and said unhappily.
Soon, the professor rushed to the office with uncontrollable excitement.
"Boss! Boss peed!" the professor whispered excitedly.
"Fu it's not the boss who peed, it's the patient who urinated normally after the surgery."
Zheng Ren was a little unhappy and corrected him. "Isn't peeing normal? You're making such a fuss about it."
Zheng Ren then said calmly, "Chief Xia, let's continue."
Professor Rudolf Wagner glanced at the scan and casually said, "Boss, it's due to an abdominal abscess... No, the density doesn't look like an abscess."
"Lil Fugui, what do you think?" Zheng Ren could not stand the professor's nonsense and decided not to explain things to Chief Xia. Instead, he asked the professor.
"Boss, I think it might be a colonic diverticulum or an abscess. This identification..."
"I think it's a colonic diverticulum. You extrapolate the digital matrix from the image and then add a reconstruction. From the perspective of transmission and absorption, it's more obvious that way," Zheng Ren said.
"Boss, you're amazing!" Professor Rudolf Wagner made an exaggerated expression and pointed at the CT scan. "I understand what you mean. It's indeed a diverticulum. There's no doubt about it!"
Chief Xia could not understand the conversation between Zheng Ren and Professor Rudolf Wagner at all. Her face was full of confusion.
Su Yun's brows were tightly knitted. After more than ten seconds, he revealed an expression of sudden realization.Find authorized novels in , faster updates, better experience, Please click #'s-studio_16489637605120805/boss-peed_50340014428569616 for visiting.
The patient's family members were at even more of a loss. They did not know why there was a foreigner who was so fluent in Mandarin at Sea City General Hospital.
"Boss, I feel that God didn't just kiss your hands, but he also gave you such a unique brain." Professor Rudolf Wagner continued to praise him. He did not feel embarrassed by his words at all. "The patient has urinated. I'll leave the urine sample for you to take a look at. It looks like the best beer in Munich."
Uh...
Zheng Ren could not understand the professor's excitement. He looked at the professor with disdain and kept a distance from him.
"I have something to do here. Go and do your work," Zheng Ren said with disdain.
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