Bleeding? Where is the bleeding point? !
The hemoglobin dropped so much that there was still 1500ml of bleeding. It wouldn’t be a large blood bag anywhere.
Malignant hemoglobin reduction caused by tumors
Not even that. In the middle stage of liver cancer, the possibility of pernicious anemia is not very high. Moreover, pernicious anemia will gradually decrease, and will not decrease so drastically in less than 24 hours.
"Is there any fluid in the abdominal cavity?" Zheng Ren asked.
"No."
Gallbladder... Pancreas... What's the problem
Zheng Ren frowned in thought, staring at the last CT scan, constantly reconstructing it in his mind.
Soon, Zheng Ren discovered the problem.
It's not the gallbladder. There is nothing wrong with the gallbladder. The problem is that some "sand-like stones" can be vaguely seen in the bile duct.
If it were an ordinary patient, this would be normal, but Zheng Ren thought of another possibility.
"Look at the patient." Zheng Ren was not pretentious and insisted on finding the answer to the question himself.
The patient's hemoglobin has dropped so low that he may die if he waits any longer.
Zhao Wenhua was overjoyed, even though he and Boss Zheng were "enemies". But when encountering difficulties, Boss Zheng is willing to help, which gives him a little more confidence.
This patient has already given Zhao Wenhua a headache.
As a doctor who is particularly averse to medical risks, Zhao Wenhua is conservative and stubborn. He is easily reluctant to try new surgical methods, and even the patients he accepts are "carefully selected."
But even so, it is difficult to guarantee that nothing will happen.
Today, I encountered it.
Zhao Wenhua took Boss Zheng to the ward. He walked in front, his steps becoming more and more sure as he walked.
The breath behind him was as calm as a mountain, and his heart didn't seem to be as panicked as before. It was like a small boat floating on the Wututu River. I didn't know when it would sink. At this time, a stone was suddenly added to stabilize the boat.
It was this feeling that Zhao Wenhua felt so clearly.
Alas, I regret that I offended Boss Zheng for a bed. As Zhao Wenhua walked, he suddenly felt depressed when he thought of what happened back then.
Zheng Ren didn't pay attention to what Zhao Wenhua was thinking at all. He was trying to find a reason and logic for his fantastic idea just now.
After a few steps, Zheng Ren became more and more steady, and he had completely figured it out.
Entering the ward, the patient was lying on the bed, the blood bag was hung on the drip stand, and blood transfusion was being performed. His lips were pale, cracked, and looked weak.
And his system panel has started to turn white from blood red.
The diagnosis on the system panel was clear—hemorrhagic shock, ruptured liver cancer.
Just as expected!
"Boss Zheng, patient..." Zhao Wenhua walked to the bedside and was about to introduce the condition and wait for Boss Zheng to check up, but then he saw that Boss Zheng did not follow him, but stood outside and waved to him.
Uh... what's going on
Some time ago, Zhao Wenhua must have thought that Boss Zheng was targeting him.
Set a trap and play tricks on yourself. I don’t know what dirty and dirty methods followed behind.
But Zhao Wenhua is still a bit pushy. A few days ago, Boss Zheng even rubbed the experts from the King's Hospital on the ground. How could he still have time to fool himself
What a big heart!
He walked out doubtfully in the strange and anxious eyes of the patient's family members.
"Boss Zheng, you..."
"I thought that after radiofrequency ablation, the shrinkage of necrotic lesions of liver cancer caused blood vessels to rupture and bleed, causing the current situation." Zheng Ren said in a low voice.
Zhao Wenhua was stunned for a moment.
Radiofrequency ablation cooks liver cancer tumors from the middle and destroys tumor cells. Scars will definitely form after surgery, and as the internal structure collapses, the periphery begins to shrink.
Judging from the imaging performance, the tumor will shrink after surgery, and smaller liver cancer will completely turn into scar tissue.
Zhao Wenhua knew all this, but he suddenly started bleeding several days after radiofrequency ablation... This situation is possible and logical, but the probability is too small.
"Are you thinking about gallbladder stones?" Zheng Ren asked with a smile.
"Yeah." Zhao Wenhua didn't hide it and nodded directly to admit it.
"I contacted Director Luo and made an appointment for an emergency gastroscopy. I went to the duodenal bulb to have a look and I will know." Zheng Rendao, "Send the patient there. By the way, call the operating room directly and prepare for emergency hemostasis."
Zhao Wenhua directly transformed into a little doctor. Even if he did not understand or understand the diagnosis of the superior doctor, he could only nod habitually.
Zheng Ren turned around and almost missed Lin Yuan.
I was startled and "jumped" away.
"Why don't you go write the medical records? Take a break when you're done. Aren't you tired from all the hard work?" Zheng Ren frowned.
I was thinking too hard about the patient's condition just now, and I didn't even notice that Lin Yuan was following me.
"Boss Zheng, how are the patient's gallbladder stones eliminated?" Lin Yuan asked in a low voice.
"That's not gallstones, it's old blood." Zheng Ren said.
"Uh... Boss Zheng, are you saying that the tumor tissue ruptured and hemorrhaged and flowed back into the gallbladder along the bile duct?" Lin Yuan thought for a while, but still had doubts, "The imaging performance of blood is not like that. I have little clinical experience. Don’t lie to me.”
Zhao Wenhua was busy and happened to hear Lin Yuan's words. He nodded repeatedly in his mind, Boss Zheng, we have little clinical experience, please don’t lie to us.
"Have you forgotten the CT positioning before radiofrequency ablation and why interventional surgery is required?" Zheng Ren said.
"Is it iodized oil?" Lin Yuan said in surprise.
"Well, it's lipiodol." Zheng Ren said, "The image after the lipiodol is dispersed is mixed with the newly emerged non-coagulated blood, and the imaging performance can be similar to silt-like gallstones."
"Uh..." Lin Yuan still had questions, but after Zhao Wenhua heard Boss Zheng's words, the fog in front of his eyes was suddenly cleared, and he suddenly became enlightened.
Think clearly about the causes and consequences.
Immortals guide the way, sometimes a word is enough.
"Boss Zheng, I understand!" Zhao Wenhua said excitedly, "Go directly to the operating room."
"There's no rush. Let's do a gastroscopy first. There are other rare possibilities." Zheng Ren said with a smile, "I'll go to the endoscopy room first and contact you by phone."
After saying that, Zheng Ren strode out.
Lin Yuan followed Zheng Ren with his ponytail swaying back and forth.
"Don't you need to write medical records?" Zheng Ren did not look back, but took out his mobile phone and started looking for Director Luo's number.
"Isn't Gu Xiaoran here? My work will be done later. Boss Zheng, I don't have much clinical experience. You need to teach me more." As he said this, Lin Yuan almost meowed out of habit.
But Boss Zheng, the steely straight man, didn't hear the hidden cry at all, but said casually, "Oh, just don't feel tired from working overtime."