A diagnosis that doesn’t exist
Lin Yuan was startled for a moment, what's going on
She was about to ask when she saw that Zheng Ren and Su Yun didn't explain at all and just left.
"Hey, Boss Zheng!" Lin Yuan called from behind.
"Huh?" Zheng Ren didn't even look back.
"Why do you say that when there is no diagnosis? Aren't you afraid that others will point out the error during the hospital-wide consultation?" Lin Yuan said anxiously.
"You mean a slap in the face?" Su Yun looked at Lin Yuan evilly with a contemptuous smile on his lips.
Well…
Lin Yuan suddenly suffered from sinus tachycardia and turned into atrial fibrillation.
"Boss Zheng, do I really want to say that?" Mr. Yu asked cautiously.
"Of course." Su Yun said with a smile: "But Mr. Yu, do you know why?"
Mr. Yu shook his head.
"The patient has calcification in his heart. Considering that he had a medical history that was not disclosed in the past, it may be that he did not disclose it on purpose; or it may have been forgotten for too long," Zheng Rendao said.
"I think it's more likely that I didn't say it on purpose." Su Yundao said.
Mr. Yu was dumbfounded. The diagnosis opinions of Boss Zheng and Brother Yun were so consistent. They even said that the patient had a hidden medical history.
This... is too scary.
"Why do you say that?" Lin Yuan followed behind and asked seriously.
"How old are you, why are you still biting your fingers? It's not wrong to call you a brat." Su Yun saw Lin Yuan biting his fingers while thinking about his condition, and started spraying.
After enduring it all day yesterday, Su Yun felt that the little beast deep in his heart was ready to move.
"Don't bite your fingernails in the hospital, it's unhygienic." Zheng Ren took a look and said with a smile.
"Boss Zheng, why are you so sure that the patient concealed his condition?" Lin Yuan was not embarrassed. All her thoughts were devoted to the patient's condition.
"Because there are no auxiliary examinations, it clearly indicates that the patient may have hematuria." Zheng Ren said casually.
"Boss Zheng, please be more detailed." Mr. Yu said with a sad face, "You can say that for the whole hospital consultation, but I can't say that."
What he said was the truth. Zheng Ren said this, and everyone must take it seriously. But if Mr. Yu told me about his medical history, he would be scolded.
"Taken together, it is certain that the patient has pericardial stenosis. Although it is not severe, it intermittently induces restricted ventricular diastolic expansion and reduced ventricular diastolic filling, resulting in a decrease in cardiac output. At the same time, the superior and inferior vena cava reflux also Obstructed by pericardial constriction, venous pressure increases, causing jugular vein distention and liver enlargement.”
"..." Mr. Yu still didn't understand.
"You mean to use constrictive pericarditis monism to explain all the clinical manifestations of the patient?" Lin Yuan frowned.
"Hey, what about monism?"
"Isn't it?" Lin Yuan asked.
"Of course not, it's just to scare the patients." Su Yun blew, his black hair flying proudly on his forehead.
"Why?" Lin Yuan suddenly didn't understand even more.
"Because the patient has a hidden medical history." Zheng Ren said, "Let's go, Mr. Yu, I'd better go to your duty room and explain it in detail."
Mr. Yu let out a sigh of relief. He was really afraid that Boss Zheng and Brother Yun would just let it go if they didn't explain clearly.
Lin Yuan followed Mr. Yu back to the duty room full of doubts. Zheng Ren sat down and said, "Mr. Yu's judgment is correct. The patient himself is hiding his medical history in order to hide the truth about the hematuria."
"But why do you do this?" Mr. Yu asked confused.
"Why, it's the answer you're looking for. It has nothing to do with the boss." Su Yundao said.
"But… "
"Didn't I just say that the patient has mild pericardial stenosis changes and can be diagnosed as constrictive pericarditis, but there will be no serious consequences." Zheng Ren said, pointing to the chest CT just now.
Mr. Yu and Lin Yuan both watched the movie silently.
"With changes in the external and internal conditions of the body, such as increased pressure in the chest and mediastinum, it is equivalent to a sudden worsening of constrictive pericarditis."
Zheng Ren talked eloquently, and Mr. Yu gradually understood what Zheng Ren meant, but Lin Yuan frowned and said nothing.
"Lin Yuan also said before that the clinical symptoms of constrictive pericarditis include increased venous pressure in the lower limbs, leading to edema of the lower limbs and other diseases. When the portal pressure increases, the renal vein pressure will also increase, and the renal pelvic venules may rupture and bleed. Related to hematuria.”
After hearing Zheng Ren narrate it from the beginning, Mr. Yu clapped his hands excitedly and said, "I'll tell you what's wrong!"
"Well, let's talk to Director Liu like this." Zheng Ren smiled, "There should be nothing wrong. The chest pressure is easy to control, which also explains why the patient refused to ask about the medical history in detail. But why did he do this? You have to ask yourself."
"What if the patient firmly disagrees with the surgery?" Mr. Yu asked.
"Originally, there was no need for surgery. I just wanted to scare him so that you could ask the truth." Su Yundao said, "Or scare his son and ask the truth."
Mr. Yu took a deep breath and nodded.
"Then let's go down. If there is any progress on your side, please contact us at any time." Zheng Ren said with a gesture of making a phone call.
"Okay!" Mr. Yu sent Zheng Ren away happily.
Lin Yuan hadn't figured it out until he went downstairs.
"Boss Zheng, why are you so sure that the patient is pretending to be ill?" Lin Yuan asked.
"Do you know why the boss came to the imperial capital?" Su Yun asked.
"It's because of the Nobel Prize project." Lin Yuan still knew about this.
"No, it was because he had clairvoyance and was kicked out of Haicheng when he peeped at the little widow taking a bath."
“…”
"Don't make trouble." Zheng Ren quickly stopped Su Yun from talking nonsense, "You have also seen the X-ray and other laboratory tests just now. Is there any clear diagnosis?"
Lin Yuan shook his head.
"Yes, all clinical examinations and physical signs do not support the symptoms, then there must be other factors involved." Zheng Rendao: "When you were in the United States, you never encountered anyone who pretended to be sick to get a comprehensive physical examination before they lost their jobs. What’s the insurance situation?”
Lin Yuan was a little embarrassed, and she shook her head blankly, "I'm just a doctoral student, and I haven't worked with patients as an intern yet."
"Boss, let's just say she is a rookie." Su Yun said disdainfully.
"They are all rookies." Zheng Ren walked down the stairs. "This is very common in clinical practice. For example, when I was in Haicheng, I went to the emergency department."
"Isn't it when you are in the hospital?"
"No, it happened during my rotation." Zheng Ren said: "The gynecologist went to dinner, and I ordered a urine test for early pregnancy, and the result was positive. If the patient quits, he will be reexamined."
"What happened next?" Lin Yuan asked puzzledly.
Now that the results are out, does reexamination make sense? Clinical laboratory errors do exist, but they are extremely rare.