Cheng Lixue was furious!
He was making things difficult for himself!
The patient's liver cirrhosis diagnosis was very clear. From the scan, the ascites was also very large. What right did he have to say that his diagnosis was wrong?!
Cheng Lixue glared at Gao Shaojie fiercely. It must be because of this Medical University professor, it must be!
Then, he glared at Zheng Ren and barely suppressed the anger in his heart. He said, "Chief Zheng, I think the diagnosis is very clear."
As soon as he said that, a rush of hot blood rushed to Cheng Lixue's head. He angrily pointed at the radiographic films on the radiographic film viewer and said, "The symptoms of cirrhosis are very obvious. The portal vein pressure is very high, and there's a lot of ascites! I don't know why Chief Zheng said that my diagnosis was wrong. Is it because you don't want to be my patient?! "
The last sentence was a little harsh.
By saying this, he had already shed all pretense of cordiality.
It meant that there was no possibility of cooperation between Cheng Lixue and Zheng Ren.
But!
Cheng Lixue couldn't tolerate it!
If this could be tolerated, what else could it be?
Motherf * cker, you actually don't want to be my patient!
Director Zhang's expression changed. He took half a step forward and stood between Cheng Lixue and Zheng Ren.
Just as he was about to speak, he heard Zheng Ren say leisurely, "Chief Cheng, did you not see the patient?"
"Hmm?" Principal Zhang was taken aback.
Cheng Lixue's face was bright red. He was also puzzled. How did Zheng Ren know that he had not seen the patient?
But how could he admit it!
He thought that Zheng Ren was deliberately slandering him. It was impossible for him to know that he did not see the patient.
Yes, just like that! He wasn't a fortune teller, so how could he know that he hadn't seen the patient?
This idea was reasonable.
Cheng Lixue became even more furious!
His hair stood on end!
However, before he could say anything, Zheng Ren asked Wang Qiang for a pen and gently pointed at the radiographic films. He said, "From the radiographic films, it does look like cirrhosis. The spleen is large, and it's in the advanced stage."
Cheng Lixue snorted.
"But Chief Cheng, did you notice that the patient's liver didn't shrink. Instead, it expanded?" Zheng Ren asked.
"…" Cheng Lixue didn't even look at the scan carefully. It was normal for the liver to not shrink …
Of course, Cheng Lixue knew that this was not normal. Although that was the case, such rare cases could occasionally be seen.
The more Cheng Lixue thought about it, the more guilty Zheng Ren was.
"This is not cirrhosis, but Budd-chiari syndrome." Zheng Ren sighed and said, "Budd-chiari syndrome is a type of retrohepatic portal hypertension caused by obstruction of the hepatic vein and the inferior vena cava above its opening for various reasons, often accompanied by inferior vena cava hypertension."
"From the looks of it, it is similar to the symptoms of cirrhosis. It was possible to make a wrong judgment, but it was usually misdiagnosed in hospitals below the county level. How could Chief Cheng not see it? It shouldn't be. "
Zheng Ren's words were very calm. There was no accusation, only doubt.
However, every word was like an invisible hand slapping Cheng Lixue's face.
"You … Impossible!" Cheng Lixue tried to defend himself.
"Chief Cheng, if you personally examine the patient, you'll definitely find that the patient has the signs of Spiderman. The veins on the surface of the abdomen are swollen, and the lower limbs are necrotic in the shape of boots. I can tell you very clearly that it's different from liver cirrhosis. "Zheng Ren's tone was still very calm.
However, the slaps were getting more and more intense.
Professor Rudolf Wagner curled his lips and was very disdainful of Cheng Lixue.
Chief Kong stood at the back with a smile. He had already seen it, but he was only a guest official. If Zheng Ren ignored it, he could just remind him in a low voice when there was no one around.
However, there was no doubt that Zheng Ren saw it.
Gao Shaojie was expressionless as he looked at the radiographic films coldly.
If Gao Shaojie's doctors, or even Wang Qiang, showed him the radiographic films of Budd-chiari syndrome as cirrhosis, Gao Shaojie would have smashed the radiographic films on the doctor's face long ago.
He could not understand it, but it would be too much if he did not even look at the patient.
Director Zhang saw that Cheng Lixue's face was flushed red and he could not say a word. He had already guessed that this guy really did not look at the patient.
He quickly tried to smooth things over and said, "Teacher Zheng …"
"Let's go take a look at the patient," Zheng Ren said. "Budd-chiari syndrome was almost incurable before interventional surgery. But with interventional surgery, it's no longer a difficult problem. "
"When interventional surgery enters the clinic, it's one of the most typical diseases. Chief Cheng really shouldn't not know about it." Zheng Ren shook his head and looked at Director Zhang.
Director Zhang was also very helpless. He asked where the patient was and brought Zheng Ren to see the patient.
The patient was lying on the hospital bed. His stomach was high and his limbs were thin. It was a typical cachexia state. Because his stomach was high and his limbs were as thin as firewood, he was lying on the bed like a big-bellied spider with only four legs.
In a trance, there was a magical feeling.
Zheng Ren glanced at the System panel on the upper right side of his field of vision. The diagnosis given on it was the same as the diagnosis he had read — Budd-chiari syndrome.
After greeting the patient and his family, Zheng Ren began to examine the patient personally.
He lifted the clothes on the patient's abdomen. Three veins about 1cm in diameter were meandering on the patient's abdomen like small snakes.
The symptoms were exactly the same as Zheng Ren's judgment in the office. There was no discrepancy at all.
All the doctors fell silent.
Zheng Ren knocked to confirm the ascites and the scope of the liver area. Then, he began to look at the patient's feet.
A pair of purple feet appeared in front of everyone.
There was blood loss, but it was not to the extent of necrosis. But even so, it was still very heavy.
Zheng Ren asked a few more questions about the medical history before bringing everyone out of the ward and back to the office.
"It's a typical arachnid. The boot-like syndrome caused by venous reflux problems in both lower limbs is also very clear." Zheng Ren returned to the front of the radiographic films, pointed at the radiographic films, and said, "So, the patient's diagnosis of Budd-chiari syndrome is already very certain."
Cheng Lixue's face was so red that it looked like blood was about to drip out.
"Chief Cheng, I remember that you went to Sea City General Hospital a few days ago and said that you wanted to learn TIPS surgery, right?" Zheng Ren said.
There was silence.
"It doesn't matter if you don't understand nuclear MRI. It's also very difficult to use nuclear MRI to determine the relationship between the portal vein and the hepatic vein in the advanced stage of cirrhosis, "Zheng Ren looked at the radiographic films and said calmly. Zheng Ren looked at the radiographic films and said calmly, "But as a doctor, as a chief physician, it's too much not to look at the radiographic films and patients before the surgery!"
Cheng Lixue was speechless. He lowered his head and took a few steps back.
"Teacher Zheng, do you think this patient can be operated on?" Director Zhang asked.
"Manager Feng, do you have vascular consumables?" Zheng Ren asked.
"Thrombolysis? I brought them. I'm preparing them for you to do thrombolysis, "Feng Xuhui said happily.
"There's no need for thrombolysis. An ordinary guide wire can do it," Zheng Ren said.
Cheng Lixue suddenly raised his head. His eyes were bloodshot. His lips moved as if he wanted to say something.
Professor Rudolf Wagner glared at him and said, "What are you looking at!"
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