Feng Jianguo thought he heard wrongly, looked at Zheng Ren with a strange expression, and asked: "Boss Zheng, what did you say?"
"Considering that the patient has myasthenia gravis, we should go for thymus CT or MR immediately. If there is thymoma, we can make a preliminary diagnosis temporarily." Zheng Rendao.
Feng Jianguo was a little confused when he saw that Zheng Ren's eyes were slightly squinted and he had been watching the movie.
He took a glance and saw that what Zheng Ren was looking at was not an abdominal CT, but a lung CT.
This film can only show a small amount of inflammation in both lungs, nothing special.
How could a thymoma be detected
But Feng Jianguo is the kind of person who has a certain mentality.
In terms of imaging, it’s okay to look at the abdominal films yourself, but if you really want to look at the chest images in detail, the level is much worse.
"Boss Zheng, is there a problem with your thymus gland?" Feng Jianguo asked carefully.
"You can't see clearly with a plain scan." Zheng Ren said: "But from an imaging point of view, the density here is wrong."
Zheng Ren clicked on the film and continued: "If it is intestinal obstruction, the patient's physical signs are wrong. The abdominal tenderness is too light to feel like it."
Feng Jianguo hesitated, but he did not question Zheng Ren's statement. Instead, he picked up his mobile phone and called Director Wei.
When something big happens, it's the most normal thing to ask the director to take the blame.
After Feng Jianguo made the call, he looked at the patient lying on the operating table and felt a little difficult.
Should we just leave the patient here and wait for the director to come up
He's never done anything like this.
Can you force the surgery? I don't think I can beat Boss Zheng.
It is said that there was a doctor at Xiangjiang Heyang Hospital who tried to force Boss Zheng and was slapped against the wall. Later, he was kicked out and raised, and now I don’t know where he is.
But even if Boss Zheng doesn't hit himself and opens his stomach and finds that there is nothing serious in his intestines, what should he do
Just sit on the wax!
Just when Feng Jianguo felt he was in a dilemma, Zheng Ren said: "How long has it been since Xinsi's Ming Dynasty was given?"
"Eight minutes." The anesthesiologist, who had detailed records, said immediately.
"We have to wait a little longer." Su Yun said, "But I see that the patient's breathing difficulty has begun to ease, and it is not as severe as when he first came in."
Zheng Ren glanced back at the patient and nodded slightly.
Feng Jianguo knew that a positive neostigmine test was a common method for diagnosing myasthenia gravis.
But after stopping the emergency surgery and doing the neostigmine test on the operating table, Boss Zheng was really confident.
As long as there is diagnosis and treatment, as long as the patient is not still lying in the operating room, anything will be fine.
"Boss, just open the chest." Su Yun said impatiently: "Get Fang Lin to come up and do mediastinoscopic thymoma resection. It will be done in half an hour."
"Don't worry." Zheng Ren said calmly: "It's just a guess. Without thymus CT and MR, it's impossible to determine whether it is a thymoma."
"It must be here!" Su Yun pointed his finger at the reader, and it made a loud bang.
These blows seemed to hit Feng Jianguo's heart, and he immediately felt symptoms of mild arrhythmia.
But Zheng Ren didn't care what Su Yun said and didn't watch the movie. Instead, he turned around and held his arms to observe the patient's condition.
5′12″ later, Director Wei hurriedly caught up.
Just after the operation, Director Wei didn't even have time to put on stockings when he had to come for emergency consultation.
"What's going on?" Director Wei asked directly after coming in.
Zheng Rengang wanted to say that when Feng Jianguo began to introduce the condition, he fell silent and continued to observe the patient's condition.
Feng Jianguo briefly explained that the patient's condition was relatively clear. Director Wei glanced at Zheng Ren and felt a little strange.
The patient has been sent to the operating table, and he directly shouts to stop. What is the difference between this and shouting to save people under the knife in the execution field
A doctor in the interventional department stopped a gastrointestinal surgery in such a domineering way... Even if they usually have a good relationship, he has to consider his own feelings.
However, Director Wei then thought about how he would feel if something happened to the patient.
Maybe Boss Zheng is more confident about the diagnosis.
He carefully found the abdominal CT film and inserted it into the reader.
Very typical intestinal obstruction! Director Wei was confused.
I took another look at the film of the gastrointestinal tract, which confirmed this even more.
"Boss Zheng." Director Wei said in a deep voice, "Are you sure?"
"You can hear what I'm saying. Open your eyes again and open them hard!" Zheng Ren said.
Director Wei was slightly annoyed. This was because he was so familiar with Boss Zheng. On the operating table, he actually let himself open his eyes and watch the movie!
wrong!
The anger was extinguished by Director Wei as soon as it appeared in his chest.
This is not a provocation, but a very strange test - the upper eyelid fatigue test!
The upper eyelid fatigue test is not a physical examination of gastrointestinal surgery. Director Wei also heard the teacher talk about it when he was in school.
Today, it was because Feng Jianguo heard that Boss Zheng was diagnosed with myasthenia gravis that he vaguely recalled what the teacher taught in class.
This disease has nothing to do with gastrointestinal surgery. I haven't encountered a single case in many years, and my memory has been covered with dust.
Because of the moment of anger, the upper eyelid fatigue test that seemed to have been forgotten long ago was remembered.
Director Wei turned around, secretly shouting that it was dangerous.
If it had been someone with a bigger temper just now, he would have exploded on the spot.
If this happens, look back and see Boss Zheng performing an upper eyelid fatigue test on the patient, wouldn't he be laughed at to death
There was an anesthesiologist standing next to him, holding a pen and paper in his hand, as if he wanted to record his momentary lapse.
"Boss Zheng, what are the results of the upper eyelid fatigue test?" Director Wei asked softly.
Zheng Ren was carefully observing the patient's condition. The anesthesiologist glanced at Director Wei and replied: "It needs to be recorded 6 times. There have been 4 recorded values. It should be positive."
Immediately, the anesthesiologist smiled and said, "Director Wei is so awesome. He can remember physical examinations that have nothing to do with your department."
"Who said there is no connection, isn't there a connection?" Director Wei forced himself to calm down, smiled slightly, and said: "If the upper eyelid fatigue test is positive, send him for a thymus CT. MR takes too long."
Zheng Ren said a value, and the anesthesiologist recorded it. After the fifth experimental physical examination, Zheng Rencai turned around and said with an apologetic expression: "I'm sorry, Director Wei, I was just doing a physical examination. What do you think?"
Director Wei felt like he was a loser.
Looking at the film, I definitely have an intestinal obstruction, and I am quite anxious and need surgery.
But Boss Zheng directly conducted an upper eyelid fatigue test, and the test result was still extremely positive.
There was a brief confrontation between my many years of clinical experience and my trust in Boss Zheng, but soon, one thought quickly took over.
"I think it is more likely to be myasthenia gravis. At least the patient's diagnosis is not clear yet. Let's do a thymus CT." Director Wei said.
"Do another upper eyelid fatigue test, and if the result is positive, go... It seems that there is no need." Zheng Ren suddenly remembered something and said: "The average value must be positive, let's just go for a CT scan."