Feng Jianguo thought he had heard wrongly. He looked at Zheng Ren with a strange expression and asked, "Boss Zheng, what did you say?"
"Considering that the patient has myasthenia gravis, immediately go for a thymus CT or MR scan. If there is a thymus tumor, we can make a preliminary diagnosis," Zheng Ren said.
Feng Jianguo saw that Zheng Ren's eyes were slightly narrowed. He had been looking at the radiographic films and was a little puzzled.
He took a glance and saw that Zheng Ren was not looking at the abdominal CT, but the lung CT.
This radiographic film could only show a small amount of inflammation in both lungs, nothing special.
How did he know it was a thymoma?
However, Feng Jianguo was the kind of person who knew what he was doing.
When it came to imaging, he could look at films related to the abdomen, but if he really wanted to look at the images of the chest in detail, his standard was much lower.
"Boss Zheng, is there something wrong with the thymus?" Feng Jianguo asked carefully.
"I can't see it clearly with a plain scan," Zheng Ren said. "But in terms of imaging, the density here is wrong."
Zheng Ren pointed at the radiographic films and continued, "If it's an intestinal obstruction, the patient's physical signs are not right. The abdominal tenderness is too light. It doesn't feel like it. "
Feng Jianguo was a little hesitant, but he did not question Zheng Ren's words. Instead, he picked up his phone and called Director Wei.
It was normal for the director to take the blame when something big happened.
After Feng Jianguo finished the call, he looked at the patient lying on the operating table and felt that it was a little difficult.
Was he going to leave the patient here and wait for the chief to come up?
He had never done such a thing before.
But forcefully twisting the surgery? He probably couldn't beat Boss Zheng.
It was said that a doctor in Hong Kong's He Hospital was slapped to the wall because he tried to persuade Boss Zheng. Later on, he was chased out and raised, and his current whereabouts were unknown.
However, even if Boss Zheng did not hit him and opened his stomach to see that his intestines were fine, what should he do?
He was directly in trouble!
Just as Feng Jianguo was in a dilemma, Zheng Ren said, "How long has Xin Si's Ming been given?"
"Eight minutes," said the anesthesiologist immediately as he had a detailed record on his side.
"We still have to wait a little longer." Su Yun said, "But I think the patient's breathing has begun to ease. It's not as heavy as when he first came in."
Zheng Ren glanced at the patient and nodded slightly.
Feng Jianguo knew that a positive neostigmine test was a common diagnostic method for myasthenia gravis.
However, after stopping the emergency surgery and performing the neostigmine test on the operating table, Boss Zheng was really full of confidence.
As long as there was treatment, it was fine as long as the patient was not left lying in the operating theater.
"Boss, just cut open the chest." Su Yun said eagerly, "Get Fang Lin to come up and perform a mediastinoscope thymoma resection. It'll be done in half an hour."
"There's no rush." Zheng Ren said calmly, "It's just a guess. Without a CT or MR scan of the thymus, we can't determine if it's a thymoma."
"This must be it!" Su Yun's finger tapped on the film viewer.
These few hits were like knocking on Feng Jianguo's heart, and he immediately felt a slight arrhythmia appear.
However, Zheng Ren did not care what Su Yun said at all. He did not look at the radiographic films either. Instead, he turned around and crossed his arms to observe the patient's condition.
After 5 '12 ", Department Director Wei hurried over.
He had just finished his surgery, and he had to rush over for an emergency consultation. Chief Wei did not even have time to put on his stockings.
"What's going on?" Director Wei asked as soon as he entered.
Zheng Ren was about to say something when he saw Feng Jianguo begin to explain the patient's condition. He fell silent and continued to observe the patient's condition.
Feng Jianguo's brief explanation of the patient's condition was relatively clear. Department Director Wei glanced at Zheng Ren and felt a little strange.
The patient had already been sent to the operating table. What was the difference between directly calling for a person to stay under the knife on the execution ground?
A doctor from the Department of Interventional Medicine used such an overbearing method to stop the gastrointestinal surgery … Even if they had a good relationship, he had to consider his own feelings.
However, Department Director Wei thought about it again. If something happened to the patient, there was no need to feel anything.
Perhaps Boss Zheng was more confident in the diagnosis.
He carefully found the abdominal CT films and inserted them into the radiographic film viewer.
It was a typical intestinal obstruction! Department Director Wei was puzzled.
He took another look at the radiographic films of the gastrointestinal tract and was even more certain of this point.
"Boss Zheng," Department Director Wei said in a deep voice, "are you sure?"
"You can hear me, right? Open your eyes again. Open them hard!" Zheng Ren said.
Department Director Wei was slightly angry. He was too familiar with Boss Zheng. He actually asked him to open his eyes and look at the radiographic films on the operating table!
No!
The anger in his chest was extinguished by Department Director Wei as soon as it appeared.
This was not a provocation, but a very unfamiliar test — the upper eyelid fatigue test!
The upper eyelid fatigue test was not a physical examination in the gastrointestinal surgery department. Department Director Wei had only heard about it from his teacher in school.
Today, because he heard from Feng Jianguo that Boss Zheng was diagnosed with myasthenia gravis, he vaguely recalled what the teacher had taught in class.
This kind of disease had nothing to do with gastrointestinal surgery. It had not been seen for many years, and his memory was full of dust.
It was because of the instant of anger that he remembered the upper eyelid fatigue test that seemed to have been long forgotten.
Department Director Wei turned around, thinking that it was a close call.
If it had been someone with a better temper just now, he would have probably exploded on the spot.
If it had happened, he would have been laughed at by Boss Zheng for the upper eyelid fatigue test later.
The anesthesiologist stood next to him, holding a pen and paper in his hand as if he wanted to record his momentary loss of composure.
"Boss Zheng, what's the result of the upper eyelid fatigue test?" Department Director Wei asked softly.
Zheng Ren was carefully observing the patient's condition. The anesthesiologist glanced at Department Director Wei and replied, "It needs to be recorded six times. There are already four recorded values. It should be positive."
Immediately, the anesthesiologist smiled and said, "Department Director Wei, you're amazing. You can even remember a physical examination that has nothing to do with your department."
"Who said there's no contact? Isn't there a connection now?" Department Director Wei forced himself to calm down, smiled slightly, and said, "If the upper eyelid fatigue test is positive, send him for a thymus CT. The MR takes too long."
Zheng Ren said a value, and the anesthesiologist recorded it. After the fifth physical examination, Zheng Ren turned around and said apologetically, "I'm sorry, Department Director Wei. I was just doing a physical examination. What do you think? "
Department Director Wei felt that he had f * cked up.
Looking at the radiographic films, it was definitely an intestinal obstruction, and it was a relatively urgent kind that needed surgery.
However, Boss Zheng directly did an upper eyelid fatigue test, and the test result was still f * cking positive.
His many years of clinical experience and trust in Boss Zheng had a brief confrontation, but soon, a thought quickly took the upper hand.
"I think the possibility of myasthenia gravis is higher. At least the patient's diagnosis is not clear. Let's do a thymus CT before we talk," Department Director Wei said.
"Do another upper eyelid fatigue test, and if the result is positive, then go … It seems that there's no need." Zheng Ren suddenly thought of something and said, "The average value is definitely positive. Let's go straight to the CT."
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