Chapter 750 Three Solutions

Seeing that Zheng Ren was still watching the film with his chin resting, Dr. Shen smiled wryly.

Boss Zheng is really a technical dog, his interpersonal communication ability is simply weak.

At this time, shouldn't I greet Director Luo politely and explain why I'm here? Someone asked you to watch a movie.

Zheng Ren didn't speak, and Dr. Shen had no choice but to bite the bullet and push forward.

"Director Luo, isn't it..." Dr. Shen waved his hands and said, "I'm here with Boss Zheng."

"..." Director Luo froze for a moment.

Boss Zheng? whose family?

Director Luo glanced at Zheng Ren, boss? Could it be this little guy with a bruised nose and a swollen face? It's the boss of the business, probably a rich second generation.

Old Kong is too outrageous, what does the doctor he brought bring a rich second generation of no age to his place? Simply... He was a little displeased, and glanced at Dr. Shen.

Dr. Shen felt the emotion in Director Luo's eyes. He knew that he would not be able to solve this matter by himself, so he grabbed Zheng Ren's sleeve and called him vigorously.

"Ah?" After Zheng Ren reconstructed the film, he compared it with the countless magazines and related cases in the periodicals he saw in the system library, and he already had a case.

"Boss Zheng, speak up." Dr. Shen whispered.

Uh... Zheng Ren realized what happened now, and he scolded himself in his heart, there is really no way to tell.

Originally, I came to the gastroenterology department to worship the pier, and I stood here stupidly, this is the rhythm of showing my butt when I want to show my face.

"Director Luo, I'm sorry, I was absorbed in watching the film." Zheng Ren bowed, tried to smile, and said.

With the advancement of technology, Zheng Ren's temperament has also improved unconsciously.

Looking at medical matters with the eyes of a mature superior doctor, Zheng Ren's attitude towards Director Luo, who went to the Department of Gastroenterology on 912, was not as rigid as that of a junior doctor, but with a hint of humility and self-confidence.

"Oh?" Director Luo felt that this little guy was a bit interesting.

Come to ask yourself to do things, although bowed to speak, but there is no trace of humility and fear in the tone.

Either the ignorant are fearless, or something else.

"Oh? What did you see?" Director Luo didn't take off the film and gave it to the patient's family to let them leave. He looked at Zheng Ren and asked leisurely.

"There is a problem with the seventeenth to nineteenth frame." Zheng Ren said.

Director Luo frowned slightly, the little doctor with a bruised nose and swollen face was right, the problematic ones were indeed those few frames of film.

It is not obvious on the image, and it is quite difficult to see it. The prefecture-level hospital where the patient is located has not given a correct diagnosis.

Is he fooled?

"You continue." Director Luo felt that things were getting more and more interesting, so he said softly.

"Director Luo's diagnosis is all right, let me add a few words." Zheng Ren stared at the film and said, "Has the patient ever had Crohn's disease?"

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 hadn't been in Director Luo's office, he would have pointed at Zheng Ren's nose and cursed.

Even the diagnosis is wrong, what kind of wolf with a big tail is pretending? !

Zheng Ren caught a glimpse of the expressions of the patient's family members and immediately knew what was going on.

"Oh, Crohn's disease is also called Crohn's disease. It was called Crohn's disease in surgical books before, so I'm used to it. Did you take mesalamine orally for a period of time and then stop taking it?" Zheng Ren didn't think there was a problem. What, speaking of.

Upon hearing mesalamine, the family members of the patient were stunned.

"How did you find out that you took mesalamine orally?" Director Luo suddenly thought that this little doctor with a bruised nose and a swollen face was interesting, so he asked.

"There are traces left after the ulcer has healed." Zheng Ren looked at this difficult film, turned on the two-line mode, and replied while thinking: "After oral administration of prednisone and mesalamine, Crohn's disease is under control , but there will be recurrence after stopping the drug.”

Director Luo looked at Zheng Ren curiously. This young man is really good at watching movies. There are indeed streaks of Crohn's disease ulcers healed on the film, but it is very atypical, and it takes a high level of film reading to notice this.

"Why oral prednisone?" Director Luo asked the question.

"Pelvic CT can see a part of the femoral head, and there are already symptoms of early avascular necrosis. Cross-referenced with other diseases, it is considered that the patient is caused by long-term oral hormone therapy during the treatment of Crohn's disease. Generally, it is combined with mesalamine The combined medication is prednisone." Zheng Ren talked eloquently, with good reason and evidence.

Director Luo nodded and said, "Continue."

"The image given by this film is considered to be a non-polypoid colorectal tumor. Unlike polypoid colorectal tumors, this type usually does not protrude into the intestinal cavity, and is flat or slightly raised. The shape of blood vessels is blurred and can be observed to uneven erythema and irregular nodules."

This sentence directly pointed to the problem, and Director Luo immediately made another revision to Zheng Ren's perception.

In general, except for professional doctors, few people can judge blurred blood vessels, uneven erythema, and irregular nodules from a CT scan.

In other words, abdominal CT generally only looks at the solid organs, and most of the intestines are seen through gastrointestinal endoscopy.

The local doctor did a plain CT scan of the patient's abdomen, probably to see if there was any tumor. After a cursory glance, I didn't see a large tumor, so I skipped it.

It's just that I didn't expect such a simple film to be spotted by Director Luo and Zheng Ren in 912.

Director Luo is also very curious, he can see it, of course. This is 912, one of the most powerful tertiary hospitals in the country. It would be strange if I couldn't see it.

But this little guy with a bruised nose and a swollen face can also see it, and he also gave an analysis based on reason, not blindly, so there is an argument.

"How do you think we should deal with it?" Director Luo asked, tapping his fingers on the back of his hand a little faster.

"There are three solutions. One is to keep a lot of intestinal tract. After surgery, colonoscopy should be done regularly to check whether there are new tumor growths in the colon. The second is to do rectostomy, but it will affect the quality of life of patients. I recommend it The third type is total colectomy and ileo-rectal anastomosis, in this case, it is enough to check the rectum regularly after surgery.”

From the perspective of a general surgeon, Zheng Ren gave three options to the patient's family and gave the best solution he considered.

There were a few words that Zheng Ren said were relatively simple, and the patient's family members could not understand them, but Director Luo knew what Zheng Ren was talking about—surgical resection of the diseased intestine and postoperative follow-up observation.

He pondered for a while, and said: "The third option can be considered, but it is safer to do a colonoscopy first."

...

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In the book review area, some book friends asked about Crohn's disease, so they found a case and wrote it out. I won't cure...