Chief Xia, I'm back. "Zheng Ren knocked on the door and came in. Chief Xia was studying the double gallbladder deformity.
"Chief Zheng, tell me about the double gallbladder deformity." Chief Xia did not put on any airs. She waved her hand and said calmly.
She wanted to stand up and give Zheng Ren a seat but was pressed down on the chair by Zheng Ren with a smile.
"Chief Xia, I don't dare to do this. Sit, sit. It's not difficult. I just need to say a few words. "Zheng Ren bent down, held the mouse in his right hand, and began to move the three-dimensional reconstruction of the MRI that he had just done.
Both nuclear MRI and CT could do three-dimensional reconstruction, but clinicians basically only knew about three-dimensional CT reconstruction. Very few people knew that nuclear MRI could also be used for reconstruction.
The resolution of CT could reach 0.5mm, but although the nuclear MRI of Sea City General Hospital was 3.0, the resolution was only 6.0mm. The three-dimensional reconstruction that was done was like a mosaic, and it looked very awkward.
Zheng Ren was simply trying to save himself some trouble and money for the patients.
The gold standard for the diagnosis of double gallbladder deformity was ERCP. However, because ERCP was an invasive examination and cost a lot, the current consensus was to use MRCP to confirm the diagnosis.
As for the three-dimensional imaging, Zheng Ren did it casually to avoid tormenting the patient and any uncertainty. It was difficult for Chief Xia.
Although Chief Xia did not deliberately misdiagnose … Basically, no one would deliberately misdiagnose, and the patient seemed to be more cooperative. However, Zheng Ren still subconsciously eliminated all hidden dangers in the bud.
"Chief Xia, look here. The patient has cystic ducts in both gallbladders." Zheng Ren used the mouse to outline the area he wanted to talk about and explained simply, "Double gallbladder deformity is divided into type 1 and type 2.
Type 1 refers to both gallbladders have
Root or
The cystic ducts above the root are independently connected to the common bile duct, 2
Type 2 can be further subdivided into
Shape mutation and trabecular mutation.
"This patient belongs to the more common type of Harlaftis
In other words, it can be treated with surgery.
"The patient does not have any symptoms of pain now. I estimate that the possibility of the patient's family agreeing to the surgery is not high. However, you can tell the patient and the patient's family that I can do this surgery. "
Chief Xia glanced at Zheng Ren. She was not surprised and did not say anything.
“1997
In Gigot
Reported a case of double gallbladder deformity. At that time, the surgeon only removed one gallbladder and left the other one. Twenty-seven months after the surgery, the patient's other gallbladder developed gallstones and acute cholecystitis. We had no choice but to remove the remaining gallbladder. "
"If it's surgery, I suggest that both gallbladders be removed."
"Of course, this is just my opinion. I think the patient still needs to go to a few more places and have a good consultation. "Zheng Ren hesitated for a moment. He wanted to say something, but in the end, he held it back.
"Chief Zheng, you've really put me on the beach," Chief Xia sighed.
"Look at what you're saying." Zheng Ren smiled and said, "I'm not."
Chief Xia picked up the instruction manual for Rocephin (ceftriaxone) from the table and waved it. "Chief Zheng, you can even memorize the instruction manual. This ability … I can't do it."
Zheng Ren smiled and did not say anything.
"Chief Zheng, how did you know?" In fact, Chief Xia did not believe that Zheng Ren could memorize the instructions.
There were at least hundreds of commonly used drugs in clinical practice.
The better the medicine, the more detailed the side effects.
According to the manual, this medicine could not be used at all.
But the more this kind of medicine was used, the better the effect. It was not like the tattered medicine produced by the Pheasant Pharmaceutical Factory. The instructions said that it could cure almost all diseases.
Therefore, it was very strange for Zheng Ren to know about this matter in Chief Xia's opinion.
How good did his memory have to be?
"Chief Xia, my medical certificate is for general surgery," Zheng Ren said. "A few years ago, have you heard of the medical accident at Liaozhou People's Hospital?"
Liaozhou was a county under Sea City. A few years ago, they performed an emergency cholecystectomy on a patient because they were diagnosed with cholecystitis and cholelithiasis.
Coincidentally, the patient's family was very serious. They insisted on seeing the stone, saying that it was a relic and wanted to keep it as a souvenir.
Before the surgery, they also gave a red packet. The chief surgeon confidently said that he must keep the stone for the patient's family. It was just a cholecystectomy. No one thought that there would be any risk.
However, after the cholecystectomy, the chief surgeon was dumbfounded.
There was no stone in the gallbladder at all.
In the end, this matter was blown out of proportion. The chief surgeon insisted that there was a gallstone in the ultrasound before the surgery and that there was no problem with his surgery. However, he did not take out the stone after the surgery and he refused to let it go.
In the end, the family pulled a banner and the commotion became bigger and bigger.
Later, the chief surgeon was suspended and the hospital lost a lot of money.
Zheng Ren was determined not to accept the red packet. It was directly related to this matter.
Just thinking about it made him feel scared. The preoperative examination was very sure that there was a stone, but the stone was not big.
However, during the surgery, the stone disappeared like a ghost.
In such a situation, how could he explain it to the patient's family? If he did not accept the money, he would be more stubborn. If he accepted the money, he would be too ashamed to show his face.
After this incident, Zheng Ren flipped through a lot of information. Before he was possessed by the System, he had already grasped the cause and effect of cholelithiasis.
Therefore, when he encountered it today, he immediately determined that it was ceftriaxone. The crystalline substance left behind by the metabolism of the gallbladder would disappear very quickly as long as the infusion was stopped.
In Zheng Ren's eyes, it was a small matter, but in Chief Xia's eyes, it was very magical.
Chief Xia thought of the medical dispute and immediately realized that the chief surgeon at that time had also encountered the same situation that she had encountered.
If it were not for Zheng Ren and she encountered a difficult family member, she would not have been able to explain how the gallstone came about.
Fortunately, she seemed to be lucky enough to meet this young Chief Zheng.
Chief Xia nodded and understood what Zheng Ren meant.
Zheng Ren did not continue to say anything. After all, when the rabbit died, the fox mourned. Talking about the chief surgeon behind his back, Zheng Ren and Chief Xia would feel a little uncomfortable.
Zheng Ren and Chief Xia would feel a little uncomfortable talking about the chief surgeon behind his back.
After chatting for a while, Chief Xia felt confident and Zheng Ren took his leave.
Could the surgery be done?
Of course it could be done.
However, Zheng Ren knew that it would be very difficult for the family to choose to have the surgery in Sea City for such a rare disease. He could only provide his opinion to Chief Xia and let her explain it to the patient's family.
The size of the temple was directly related to the incense offerings of the Bodhisattva.
Moreover, he was the type who was too young. It was difficult for the patient's family to trust him.
If it were the Imperial Capital or Sorcery Capital, Zheng Ren might have directly explained the situation to the patient's family and performed the surgery.
On this point, Zheng Ren was quite aware of it.
He was not in a hurry. Zheng Ren slowly returned to the emergency ward, looked at the patients, and then continued to sit down to read.
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