Dr. Shen smiled bitterly when he saw Zheng Ren still holding his chin up to watch the movie.
Boss Zheng is really a technical dog, and his interpersonal communication skills are simply weak.
Shouldn't we greet Director Luo politely at this time and explain our intention? Who asked you to watch a movie
Zheng Ren didn't say anything, and Dr. Shen had no choice but to bite the bullet and push forward.
"Director Luo, no, no..." Dr. Shen waved his hand and said, "I am here with Boss Zheng."
"..." Director Luo was stunned for a moment.
Boss Zheng? Whose family is it
Director Luo glanced at Zheng Ren, boss? Are you talking about this little guy with a bruised nose and a swollen face? He's the business owner, probably a rich second generation.
Lao Kong is too shameless. Why did his Ph.D. bring a wealthy second-generation person to his place? Simply... He was a little unhappy and glanced at Dr. Shen.
Dr. Shen felt the emotion in Director Luo's eyes. He knew that he would definitely not be able to solve this problem, so he pulled Zheng Ren's sleeve with his hand and called him hard.
"Ah?" Zheng Ren reconstructed the film and compared it with the relevant cases in countless magazines and periodicals seen in the system library, and he already had a clue.
"Boss Zheng, please speak." Dr. Shen whispered.
Uh... Only then did Zheng Ren realize what happened, and he cursed himself in his mind. He really didn't have a clue.
I originally came to the Department of Gastroenterology to pay homage to the dock, but I stood here dumbfounded. This is the rhythm of exposing my butt when I want to show my face.
"Director Luo, I'm sorry, I was fascinated by the movie." Zheng Ren bowed and tried to show a smile.
As the level of technology improved, Zheng Ren's temperament also made a leap unconsciously.
He looks at medical-related matters with the eyes of a mature senior doctor. Even towards Director Luo of the 912 Department of Gastroenterology, Zheng Ren's attitude is not as restrained as that of a young doctor, but with a hint of humble confidence.
"Oh?" Director Luo thought this little guy was a bit interesting.
When he came to ask for help, even though he bowed and spoke, there was no trace of humility or fear in his tone.
Either the ignorant are fearless, or there is something else going on.
"Oh? What did you see?" Director Luo didn't take off the film, gave it to the patient's family, and asked them to leave. He looked at Zheng Ren and asked leisurely.
"There is a problem from frames 17 to 19," Zheng Ren said.
Director Luo frowned slightly. The little doctor with a bruised nose and face was right. The problematic frames were indeed those frames.
It was not obvious on the images and it was very difficult to see. The prefecture-level hospital where the patient was located did not give a correct diagnosis.
Is he blind
"You continue." Director Luo felt that things were getting more and more interesting, and he said softly.
"Director Luo's diagnosis is correct. 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 boredom. It seemed that if he hadn't been in Director Luo's office, he would have pointed at Zheng Ren and cursed.
Even the diagnosis was wrong, why are you pretending to be a big-tailed wolf? !
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, also called Crohn's disease. In the old surgery books, it was called Crohn's disease. I'm used to it. Did you take mesalazine orally for a period of time and then stop taking it?" Zheng Ren didn't think so. What, speaking of.
When they heard about mesalazine, the patient's family members were stunned.
"How did you know that mesalazine was taken orally?" Director Luo suddenly found this little doctor with a bruised nose and face very interesting, so he asked.
"There are traces left after the ulcer healed." Zheng Ren looked at this difficult film, turned on the dual-line mode, and replied while thinking: "After oral prednisone and mesalazine, Crohn's disease was controlled , but there will be recurrence after stopping the medication.”
Director Luo looked at Zheng Ren curiously. This young man was really good at watching movies. There are indeed traces of streaks formed after the ulcers of Crohn's disease heal on the film, but they are very atypical and require a high level of film reading to notice this.
"Why oral prednisone?" Director Luo asked the question.
"A part of the femoral head can be seen on pelvic CT, and there are already symptoms of early avascular necrosis. By cross-reference with other conditions, it is considered that the patient was caused by long-term oral hormone therapy when treating Crohn's disease. Generally, it is treated with mesalazine The combined medication is all prednisone." Zheng Ren talked eloquently, showing no timidity and being well-founded.
Director Luo nodded and said, "Continue."
"The image given by this film is considered to be a non-polypoid colorectal tumor. Unlike polypoidal colorectal tumors, this type of tumor usually does not protrude into the intestinal lumen and is flat or slightly bulging. The blood vessels are blurred and can be observed. to uneven erythema and irregular nodules.”
This sentence pointed directly to the problem, and Director Luo immediately made another revision to Zheng Ren's understanding.
Generally speaking, except for doctors who are very professional in looking at films, few people can judge the blurred blood vessel shape, uneven erythema, and irregular nodules from a CT film.
In other words, abdominal CT generally only looks at solid organs, and most of the intestinal tract is looked at through a gastrointestinal endoscope.
The local doctor performed a CT scan of the patient's abdomen, probably to see if there was any tumor. After a cursory glance, I didn't see any big tumors, so I just ignored them.
I just didn't expect that such a simple picture would be seen 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 you couldn't tell.
But this little guy with a bruised nose and swollen face can also see it and give a rational and well-founded analysis. He is not blind. This has an explanation.
"What do you think should be done?" Director Luo asked, tapping the back of his hand a little faster with his fingers.
"There are three solutions. One way is to preserve more intestines, and colonoscopy should be done regularly after surgery to check whether there is any new tumor growth in the colon. The second way is to make a rectostomy, but it will affect the patient's quality of life. I recommend it. The third option is total colectomy and ileo-rectal anastomosis. In this case, you only need to check the rectum regularly after the operation."
From the perspective of a general surgeon, Zheng Ren gave the patient's family three options and gave him the best solution he considered.
There were a few words that Zheng Ren said that were relatively simple and could not be understood by the patient's family, but Director Luo knew what Zheng Ren was talking about about surgical resection of diseased intestines and postoperative follow-up observation.
He pondered for a moment and said: "The third option can be considered, but it is safer to do a colonoscopy to obtain pathology first."
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In the book review area, a book friend asked about Crohn's disease, so I found a case and wrote about it. I won't cure it...