Seeing that Zheng Ren was still watching the radiographic films with his chin on his hand, Chief Resident Shen smiled bitterly.
Boss Zheng was really a technical dog. His interpersonal communication skills were simply too weak.
Shouldn't he greet Chief Luo politely and explain his purpose of coming? Who the f * ck asked him to watch the radiographic films?
Zheng Ren did not say anything, so Chief Resident Shen had no choice but to bite the bullet.
"Chief Luo, no, no …" Chief Resident Shen waved his hand and said, "I came with Boss Zheng."
"…" Chief Luo was stunned.
Boss Zheng? Who was it?
Chief Luo glanced at Zheng Ren. Boss? Could he be talking about this bruised and swollen little guy? He was probably the boss of a business. He was probably a rich second-generation heir.
Old Kong was too outrageous. Why did he bring a rich second-generation heir with him to his place? It was simply … He was a little unhappy and glanced at Chief Resident Shen.
Chief Resident Shen felt the emotion in Chief Luo's eyes. He knew that he would definitely not be able to solve this matter, so he used his hand to tug at Zheng Ren's sleeve and called him hard.
"Huh?" After Zheng Ren finished reconstructing the radiographic films, he compared them with the relevant cases in the countless magazines and journals he had seen in the System library. He already had a plan in mind.
"Boss Zheng, say something," Chief Resident Shen said softly.
Uh … Only then did Zheng Ren realize what had happened. He scolded himself in his heart. He really did not know what was going on.
Originally, he had come to the gastrointestinal department to pay his respects. He stood there in a daze. This was the rhythm of wanting to show his face but revealing his butt.
"Chief Luo, I'm sorry. I was too engrossed in watching the radiographic films." Zheng Ren bowed and tried his best to show a smile.
With the improvement of his technical level, Zheng Ren's temperament had unknowingly improved.
He used the eyes of a mature senior doctor to examine medical related matters. Even when facing Chief Luo of the 912's gastrointestinal department, Zheng Ren's attitude was not as reserved as a young doctor. Instead, it was with a hint of confidence and humility.
"Oh?" Chief Luo felt that this little guy was a little interesting.
He came to ask him to do something. Although he bowed and spoke, there was not the slightest bit of humility or fear in his tone.
If it was not that the ignorant were fearless, then there was something else.
"Oh? What did you see? "Chief Luo did not take off the radiographic films. He gave them to the patient's family and let them leave. He looked at Zheng Ren and asked leisurely.
"There's a problem with frames 17 to 19," Zheng Ren said.
Chief Luo frowned slightly. This young doctor with a swollen face was right. The problem was indeed with those radiographic films.
It was not obvious on the imaging, and it was very difficult to see it. The city hospital where the patient was located did not give the correct diagnosis.
Was he just guessing?
"Continue," Director Luo said softly as he felt that things were getting more and more interesting.
"There's no problem with Chief Luo's diagnosis. Let me add a few words." Zheng Ren stared at the radiographic films and said, "Has the patient ever had Crohn's disease?"
The patient's family looked at each other and shook their heads.
One of them looked at Zheng Ren with some annoyance. It seemed that if they were not in Chief Luo's office, they would definitely point at Zheng Ren's nose and scold him a few times.
Even the diagnosis was wrong. What was he pretending to be?!
Zheng Ren caught a glimpse of the patient's family members' expressions and immediately knew what was going on.
"Oh, Crohn's disease, also known as Crohn's disease. It used to be called Crohn's disease in surgery books. I'm used to it. Did he take mesalazine orally for a period of time and then stop taking it? "Zheng Ren did not think anything was wrong.
When he heard the word mesalazine, the patient's family was stunned.
"How did you see that he took mesalazine orally?" Chief Luo suddenly felt that this young doctor with a bruised nose and swollen face was quite interesting, so he asked.
"There are traces left behind after the ulcer healed." Zheng Ren looked at the difficult radiographic films and turned on the double-line mode. As he thought, he answered, "After taking prednisone and mesalazine orally, Crohn's disease was controlled, but after stopping the drug, there would be relapses."
Chief Luo looked at Zheng Ren curiously. This young man's standard of reading radiographic films was indeed not bad. There were indeed traces of the ulcer of Crohn's disease on the radiographic films, but it was particularly atypical. One had to be very good at reading radiographic films to notice this.
"Why did he take prednisone orally?" Chief Luo asked the question.
"The pelvic CT can see a part of the femoral head. There are already symptoms of ischemic necrosis. Comparing it with other conditions, we consider that the patient was treated for Crohn's disease and was caused by long-term oral hormone treatment. Usually, prednisone is used in combination with mesalazine, "Zheng Ren spoke frankly and confidently. He did not show any fear and was reasonable.
Chief Luo nodded and said, "Continue."
"The image given by this radiographic film is considered to be a non-polypoid colorectal tumor. Unlike polypoid colorectal tumors, this type of tumor usually does not protrude into the intestinal lumen. Its shape is flat or slightly bulging. The shape of the blood vessels is blurred, and uneven erythema and irregular nodules can be observed. "
This sentence pointed straight to the problem. Chief Luo immediately made another change in his understanding of Zheng Ren.
Under normal circumstances, other than doctors who were very professional at reading radiographic films, very few people could determine the blurred shape of the blood vessels, uneven erythema, and irregular nodules from a single CT radiographic film.
In other words, abdominal CT scans usually only looked at the substantial organs. Most of them looked at the intestines through gastroenteroscopy.
The local doctor did a plain CT scan of the patient's abdomen, probably to see if there was a tumor. He took a cursory glance and did not see any large tumors, so he skipped it.
However, he did not expect that such a simple radiographic film would be seen by Chief Luo and Zheng Ren in the Imperial Capital Hospital.
Chief Luo was also very curious. It was only natural that he could see it. This was the Imperial Capital Hospital, one of the most powerful Class Three Grade A Hospitals in the country. It would be strange if he could not see it.
However, this little guy with a bruised nose and swollen face could also see it. He even gave a reasonable analysis and was not blindly guessing. This made sense.
"How do you think we should deal with it?" Chief Luo asked. The speed at which his fingers tapped the back of his hand increased.
"There are three solutions. One is to preserve more intestines. After the surgery, we have to do colonoscopy regularly to check if there are new tumors growing in the colon. The second is to do a rectostomy, but it will affect the patient's quality of life. I suggest the third method, total colectomy and ileorectal anastomosis. In that case, we only need to check the rectum regularly after the surgery. "
From the perspective of a general surgeon, Zheng Ren gave the patient's family three choices and gave them the best solution that he had considered.
There were a few words that Zheng Ren said were relatively simple. The patient's family did not understand, but Chief Luo knew what Zheng Ren was talking about — surgical removal of the diseased intestine and follow-up observation after the surgery.
He pondered for a moment and said, "The third plan can be considered, but it's safer to do colonoscopy first to take the pathology."
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