Chapter 2148 Coquettish Operation

Feng Xuhui was taken aback by Su Yun's words.

Isn't the diagnosis already clear? Although he was not a doctor, Feng Xuhui knew about the adrenal crisis. The illness is serious and urgent, that's for sure. However, the medical level of the Affiliated Hospital of Medical University is high, which cannot be denied, and there should be no danger for people.

Brother Yun said something serious happened!

"A plausible diagnosis, renal vein thrombosis leading to adrenal crisis. There was even a hematoma caused by bleeding. It was just too coincidental, like the diagnosis of acute appendicitis in a young boy with sudden metastatic right lower quadrant pain, nothing to think about at all .”

Feng Xuhui looked at Su Yun blankly. When it came to the patient's medical history, symptoms, objective examination, final diagnosis, etc., he couldn't get in a word.

"It's fine if there's nothing wrong with this kind of thing. Once something happens, it's a big deal."

"For example?"

"For example, renal vein thrombosis can be said to be caused by oral contraceptives. We have also done this kind of patient, that is, the medical student who fell down." Su Yunbi said with gestures.

While explaining the illness to Feng Xuhui, Su Yun was sorting out his thoughts.

Feng Xuhui has an impression of this operation. Boss Zheng removed a 12cm large thrombus, and he still remembers it vividly.

"But it's so coincidental, I feel uneasy just looking at it." Su Yun smiled.

Brother Yun's judgment is too idealistic. Feng Xuhui didn't believe it, he still felt that the adrenal crisis alone was enough.

"The patient had repeated orthostatic syncope for 7 days, hyponatremia, adrenal crisis was clearly diagnosed, and hypotension was the main cause of the syncope." Su Yun chattered casually, "Well, hyponatremia is what you said, and Not very obvious, this diagnosis is not considered for the time being.”

"Adrenal insufficiency leads to adrenal crisis. Common causes of primary adrenal insufficiency include adrenal tuberculosis, fungal infection, solid tumors, and autoimmune diseases."

"I guess the Affiliated Hospital of the Medical University will also check one by one."

Su Yun babbled up to this point, so he stopped talking. It's meaningless to continue talking, it's just a waste of saliva.

All, we have to wait until we see the limited laboratory test results.

Zheng Ren and the professor operated together, and the speed was not very fast. Because the professor was about to leave, Zheng Ren was extra serious, and every problematic step had to be corrected repeatedly.

After the operation was completed, Zheng Ren walked out of the operating room, and all kinds of information from Lin Yuan were also passed on.

Su Yun dragged Lin Yuan into the group, and the moment he entered the group, Chu Yanran's head flickered.

A series of welcome words made Lin Yuan feel that it was definitely worth the money to find his old man to do business this time.

Only when you join the group can you be regarded as one of your own.

She seized the time to upload the materials, and then watched Gu Xiaoran pick up the patients and go to the next operation.

"There are no major problems in the blood test." Su Yun and Zheng Ren said.

"Cortisol 0.74 μg/dl, ACTH 356 PG/ml, normal thyroid function; supine RAAS showed plasma renin activity 3.29 ng/(ml·h), aldosterone <59 pg/ml; standing RAAS It shows PRA 6.37 ng/(ml h), ALD 78.1 pg/ml."

He picked out the question and said that Zheng Ren just nodded, apparently in deep thought.

In addition, the abdominal enhanced CT showed the same results as Zheng Ren and Su Yun judged—the bilateral adrenal glands were diffusely swollen and enlarged, and the left and right sides were 3.2 cm×3.4 cm and 2.5 cm×4.9 cm respectively, with clear borders , uneven density.

The CT value was 36~65HU, no clear enhancement was seen in the enhanced scan, and the possibility of adrenal hematoma was high.

The left renal vein was dilated, and an irregular low-density lesion with a length of about 2.3 cm was seen in the lumen; a low-density plaque with a length of about 0.8 cm was also seen in the right renal vein, and the possibility of thrombus was high.

"Boss, do you see the problem?" Seeing that Zheng Ren didn't speak, Su Yun asked.

"It was said in the case that the patient had hyperpigmentation." Zheng Ren said.

The physical examination at the Affiliated Hospital of Medical University was very detailed, and described the suprasternal fossa, armpits, waist and abdomen, auricles, palm lines of both hands, skin pigmentation on the back of the index finger, and pigmentation of the lips and oral mucosa.

Scattered herpes can be seen on the left nose. The skin of the double mandibular is hyperpigmented, and scattered papules can be seen, and part of the surface is ulcerated.

These were not described by Feng Xuhui.

"I see, tuberculosis is not considered, adrenal gland fungal infection..."

"I don't even think about it." Zheng Ren said affirmatively.

"Adrenal gland tumors have also been ruled out, so it might be an autoimmune system disease." Su Yun said with a smile, "I should ask Dabai to have a look."

"No need, the illness... I'll think about it again." Zheng Ren said.

"Everything that can be ruled out is ruled out. I guess it's antiphospholipid syndrome."

"Well, secondary." Zheng Ren added.

"Any thoughts on treatment?"

Zheng Ren thought for a while, and began to discuss with Su Yun.

This time it was a very professional conversation, and Feng Xuhui couldn't keep up with it from the very beginning.

In the conversation between Zheng Ren and Su Yun, every noun had to be pondered for a long time. Before he could figure out the content of the first sentence, Mr. Zheng and Brother Yun had already reached the tenth sentence.

Forget it, Feng Xuhui gave up trying to figure it out with his own brain, and in the end all he needed was Mr. Zheng and Brother Yun to give him an answer.

It was quite interesting just watching the two of them discussing their condition.

Mr. Zheng is still the same Mr. Zheng from Haicheng, honest and honest, he speaks with a straight line, like a dying old professor, citing classics. Brother Yun didn't change much either. If he didn't say a word to Mr. Zheng, he would feel uncomfortable all over.

The two talked like they were arguing for nearly half an hour, and the Xie Yi people got used to it, and didn't listen to what the two of them were talking about, and kept staring at the surgery inside.

After one operation was over, the two were still arguing. It sounds like they were speculating on possible tests that have not yet been reported based on the existing test results.

This is a non-human operation, Feng Xuhui is a little at a loss, is it right to do this?

After the operation was over, Mr. Zheng explained the operation to Fu Gui'er during the interval. Brother Yun found a pen and paper and began to write.

Facing Su Yun's coquettish operation, Feng Xuhui had no idea what he was doing.

In this way, time passed quickly between Zheng Ren and Su Yun arguing about the disease and seeing the operation.

After the last operation, Su Yun took a stack of papers and said with a smile: "That's it, the diagnosis is secondary antiphospholipid syndrome."

"Um."

"Secondary antiphospholipid syndrome, systemic lupus erythematosus, bilateral adrenal vein thrombosis followed by adrenal hematoma; primary adrenal insufficiency; adrenal crisis."

Su Yun wrote while speaking, with black hair fluttering on his forehead, looking extremely proud.

After Su Yun finished writing, Zheng Ren took a look at it and added a smiley face at the end.

"Boss, they say it's useless for you to do this."

"I'm used to it." Zheng Ren smiled and handed over a dozen A4 sheets to Feng Xuhui.