Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation
Chief Resident Shen smiled bitterly when he saw that Zheng Ren was still looking at the films with his chin resting on his palm.
Boss Zheng was really a slave to his technical skills. His ability to communicate with people was really weak.
Shouldn’t he have politely greeted Chief Luo at this point and explained the purpose of his visit? Who the f*ck was asking him to just stare at the radiographic films?
Zheng Ren didn’t say anything, so Chief Resident Shen had no choice but to bite the bullet and go forward.
“Chief Luo, isn’t it…” Chief Resident Shen waved his hand and said, “I’m here with Boss Zheng.”
Chief Luo was stunned.
Boss Zheng? Whose family is he from?
Chief Luo glanced at Zheng Ren. Boss? Could he be talking about this bruised and swollen little guy? He must be the boss of a businessman, some kid rich off his father’s business.
Department Chief Kong was too outrageous. Why did he bring a rich person’s son with him? It was simply… He was a little displeased and glanced at Chief Resident Shen.
Chief Resident Shen could sense the discomfort coming from Chief Luo. He knew that he could not solve this matter, so he pulled Zheng Ren’s sleeve and called out to him.
“Ah?” After Zheng Ren finished rebuilding the radiographic films, he compared them to other related cases in the countless magazines and periodicals in the System library. He already had an idea of what was going on.
“Chief Resident Shen, please say something,” Chief Resident Shen said in a low voice.
Eh… Zheng Ren finally realized what had happened. He cursed himself in his heart. He really didn’t know what to do.
He had originally come to the gastrointestinal department to pay respects to his peers but now, he stood there in a daze. This was just like showing his butt when he wanted to show his face.
“Chief Luo, I’m sorry. I was too engrossed in watching the radiographic films,” Zheng Ren said as he bowed and tried his best to smile.
With the improvement of his skills, Zheng Ren’s temperament had unknowingly taken a leap.
Using the eyes of a mature senior doctor to examine matters related to medical treatment, even when faced with Chief Luo from Imperial Capital Hospital’s gastrointestinal department, Zheng Ren’s attitude was not as reserved as that of a young doctor. Instead, it carried a hint of humble confidence.
“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 a trace of humility or fear in his tone.
If it was not because he was ignorant and fearless, then there must be something else.
“Oh? What do you see?” Chief Luo did not take off the radiographic films. He gave them to the patient’s family members and asked them to leave. He looked at Zheng Ren as he leisurely asked the question.
“There’s a problem with frames 17 and 19,” Zheng Ren said.
Chief Luo frowned slightly. This bruised and swollen junior doctor was right. The problem was indeed with those few radiographic films.
The radiographic films were not clear, making it rather difficult to see it. The city-level hospital where the patient had initially gone to did not give the correct diagnosis.
Was he just making a stab in the dark?
“Continue,” Chief Luo said softly as he felt that things were becoming more and more interesting.
“There’s no problem with Chief Luo’s diagnosis. Let me add a few more words.” Zheng Ren stared at the radiographic films and said, “Did the patient suffer from Crohn’s disease before?”
The patient’s family members looked at each other and shook their heads.
One of them looked at Zheng Ren with some annoyance. It seemed that if he was not currently in Chief Luo’s office, he would definitely point at Zheng Ren and scold him.
He even made a mistake in the diagnosis. How could he act so high and mighty?!
Zheng Ren caught a glimpse of the patient’s family members’ expression and immediately knew what was going on.
“Oh, Crohn’s disease is also known as enteritis. In previous surgical books, it was called Crohn’s disease. I’m used to that term. Did you take mesalazine orally for a period of time for treatment and then stop?” Zheng Ren said, not thinking much about it.
When he heard the term ‘mesalazine’, the patient’s family was stunned.
“How did you know the patient was taking mesalazine orally?” Chief Luo asked, suddenly feeling that this bruised and swollen junior doctor was quite interesting.
“There are traces left behind after the ulcer healed.” Zheng Ren looked at this difficult radiographic films and switched to a two-line mode. While still deep in thought, he answered, “After taking prednisone and mesalazine orally, the Crohn’s disease was controlled but there would be a relapse after the medication was stopped.”
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 ulcers of Crohn’s disease that formed after they healed on the radiographic films, but it was especially atypical. One had to have a high standard of reading radiographic films to notice this.
“Why oral administration of Prednisone?” Chief Luo asked the question.
“A part of the femoral head can be seen on the pelvic CT. there are already signs of early ischemic necrosis. Cross-referencing with the other conditions, the patient is considered to be suffering from Crohn’s disease caused by long-term oral hormone treatment. Generally, when combined with mesalazine, it is prednisone,” Zheng Ren said with assurance. He was firm with his answer.
Chief Luo nodded and said, “Continue.”
“The image given by this radiographic films is considered to be a non-polyposis colorectal tumor. Unlike polyposis colorectal tumors, this type usually does not protrude into the intestinal cavity. Its shape is flat or slightly elevated. The shape of the blood vessels is indistinct. Uneven red spots and irregular nodules can be observed.”
This sentence directly pointed 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 in looking at radiographic films, very few people could determine the indistinct shape of the blood vessels, uneven red spots, and irregular nodules from a single radiographic film.
In other words, abdominal CT usually only looked at the solid organs. Most of the time, when it came to looking at the intestines, it was through the gastrointestinal colonoscope.
The local doctor performed a plain CT scan on the patient’s abdomen. He probably wanted to see if there was a tumor. After a rough scan, he did not see a large tumor, so he skipped it.
He just did not expect that Chief Luo and Zheng Ren would be able to see through such a simple radiographic film while at the Imperial Capital Hospital.
Chief Luo was also very curious. It was only natural that he could see through it. This was the Imperial Capital Hospital. It was one of the most powerful Class Three Grade A Hospitals in the country. It would be strange if he could not see through it.
However, this little fellow with a bruised face could also see it. He even gave a reasonable analysis. It was not a blind guess. There was a reason for that.
“How do you think we should deal with it?” Chief Luo asked. The speed at which his fingers hit the back of his hand increased by a few degrees.
“There are three solutions. One is to preserve more of the intestinal tract. After the surgery, we need to perform a colonoscope periodically to check if there are any new tumors growing in the colon. The second solution is to perform a rectal fistula, but it will affect the patient’s quality of life. I would recommend the third solution, which is total colectomy and ileum-rectal 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 options and gave them the best solution he could think of.
There were a few words that Zheng Ren said that were relatively simple. The patient’s family could not understand him, but Chief Luo knew what Zheng Ren was talking about—surgical resection of the diseased intestine and follow-up observation after the surgery.
He pondered for a moment and said, “The third option can be considered, but it’s still safer to do a colonoscopy for pathology first.”
