"Ears? What's wrong with his ears?" She took a look, but did not notice the small keratoma on his ears.
The keratoma was very small, protruding only a few millimeters from the surface of his body. It was red, and if one did not look carefully, they would not be able to see it at all. Even if one looked carefully, they would not think that there was something wrong with it.
Zheng Ren tried his best to squeeze out a smile. Not far away, there was a commotion at the hospital. His smile looked so forced.
"Wang Dong, when do you feel pain?" Zheng Ren tried his best to ask gently to avoid provoking Wang Dong and his mother.
If they really called the police and said that he was trying to abduct and sell children, it would become a joke.
"Uncle, my arms and legs often hurt, especially after running. I just had PE class, and the pain was unbearable," Wang Dong said timidly. "I'm not pretending to be sick. I really am not pretending to be sick. I want to have PE class..."
"Have you been in pain since you were young?" Zheng Ren asked again.
"It was fine when I was young, but it's getting more and more painful. Now I don't even dare to exercise, but I envy them for being able to play football." Wang Dong finally found a person who did not say that he was pretending to be sick, and he tried his best to vent his grievances.
"Can I take a look at the child?" Zheng Ren looked at Wang Dong's mother and tried his best to smile gently. However, he immediately thought that it was better to let Su Yun do this kind of thing. The bruise on his face had not completely healed, so his smile probably made him look more like a bad person.
"Are you a doctor from 912?" Wang Dong's mother asked, looking at Zheng Ren vigilantly, then looked at the crowd of people who were causing trouble at the Pediatric Emergency Department.
"Boss, if you want to talk about your habit of causing trouble for no reason, this is really beneath my notice." Su Yun stood behind Wang Dong and looked at him carefully. He did not see any problems, and it was obvious that Wang Dong's mother did not trust Zheng Ren, and so rebuked him.
"Fabry Disease is very rare. If you don't believe me, I suggest that you go in and find a doctor from 912 to have a look, and then do a check-up to find out." Zheng Ren was not angry. He continued to explain, "The earlier the diagnosis, the earlier the treatment. It's no big deal."
Chapter 797 - Eye of the Storm
"What illness?" Wang Dong's mother was stunned.
Was he really sick? Or was it something...something that he did not remember.
It could not be. Wang Dong was complaining of pain every day, and his whole body was uncomfortable. However, nothing happened to him. He did not even have a cold or fever. He should just eat and drink.
Impossible!
Impossible..,
"Boss, is Fabry disease caused by the congenital deficiency of alpha-galactosidase A in the patient's body?" After listening to Zheng Ren's words, Su Yun also realized something. He carefully looked at the keratoma on Little Wang Dong's ear and thought hard.
This kind of disease was very rare. If Su Yun was not well-read and knowledgeable, few people would know about it.
However, Su Yun read books for the sake of bragging at the table. He did not expect to meet such a patient one day.
"Yes, there is a blood vessel keratoma on the ear. This is a mid-term performance. I guess if we do a physical examination, we can see the turbid vortex cornea in the eyes." Zheng Ren looked at Wang Dong's mother and asked patiently, "Can I take a look at Wang Dong's eyes?"
Seeing Zheng Ren's serious face, Wang Dong's mother still believed him even though there were some yellowed bruises on his face and it looked funny.
It was just a look at the eyes. It was broad daylight and clear skies. What was there to be afraid of?
She nodded and placed her hands on Wang Dong's shoulders. She could use force at any time to pull the child into her arms.
Zheng Ren smiled and said, "Little Brother, don't be nervous. I'll just flip your eyelids."
Su Yun was also curious. He recalled that the typical characteristic of Fabry disease was the turbid vortex cornea in the eyes.
One look was 80% sure of the diagnosis.
He came in and saw Zheng Ren reach out and gently lift Wang Dong's eyelids. In just a moment, he put it down.
Before Wang Dong could react, and before Wang Dong's mother could let her imagination run wild, the physical examination had already ended.
Of course, if it was a detailed examination, the patient's lower abdomen, t.h.i.g.hs, and other areas would also have to be examined. There would be red or purplish-black hemangiokeratoma there. However, since there was a hemangiokeratoma on the ear, these places became a lot less important.
"It really looks like an eye of the storm." Su Yun saw it clearly and sighed.
The eye's vortex-like cornea was turbid. If one observed it carefully and clearly, they would discover that it was like an eye of the storm existing in the patient's cornea.
This was a very typical characteristic. It was different from normal cornea diseases.
"What's the matter?" Wang Dong's mother asked doubtfully.
"It should be Fabry disease. Su Yun, do you have a pen and paper?" Zheng Ren asked.
Su Yun opened his arms, indicating that he did not have anything on him.
"Chief Zheng, I have one here." Chang Yue took out a small notepad and a pen from her bag and handed it to Zheng Ren.
Zheng Ren thought for a moment and wrote down on the notepad: 'Diagnosis: Fabry's disease. It is recommended that a test for alpha-galactosidase be done. If there is a positive result, the enzyme would be used as an alternative treatment.'
After writing down a line of words, Zheng Ren wrote down the words 'Interventional Department' and 'Zheng Ren' at the bottom. He tore off the page and handed it to Wang Dong's mother.
"I have written down the diagnosis, what tests should be done, and the treatment. Keep this well and go to the Emergency Department...or go to the Rheumatology and Immunology Department to have a look." Zheng Ren smiled and turned around to leave.
He handed the notepad and pen to Chang Yue, and the few of them left.
Xie Yiren looked at Zheng Ren with sparkling eyes. In her eyes, Zheng Ren was really handsome at this time.
"Boss, you made a diagnosis because of the blood vessel keratoma on the child's ear?" Su Yun still did not understand and asked.
"Fabry's disease is often misdiagnosed as rheumatism, arthritis, growth pain, or psychogenic pain in the early stage. It's even thought that the patient is faking the disease.
"I heard from Wang Dong's mother that the disease has been diagnosed many times, but no problem has been found," Zheng Ren said as he walked. "So, think about where it is possible."
"The blood vessel keratoma on the ear is a typical feature, but it cannot be diagnosed. In the end, it was only confirmed after looking at the cornea."
Zheng Ren did not think much of it and said it casually.
"Then you were so sure before." Su Yun was still confused.
"I'm not sure. Wang Dong's mother can't let him see it either," Zheng Ren said casually.
"..." Su Yun was speechless. "What if the diagnosis is wrong?"
"Just look at the cornea. If It's wrong, then it's wrong. Do you care? If It's wrong, I'm just an ordinary passerby. By the way, I'm a doctor from 912."Zheng Ren looked at Su Yun seriously.
"Uh..." This was the first time Su Yun heard this kind of nonsense from Zheng Ren.
Zheng Ren was usually honest and straightforward. He did not seem to be as slick as the usual Zheng Ren.
However, Su Yun thought about it again. The situation just now was a mess with the Emergency Department causing trouble. Zheng Ren really did not have any good ideas.
If it were him, things might have been a little simpler.
Was there a human trafficker as handsome as him? With such a stunning appearance, would doing anything not earn more than being a human trafficker?
Well, this was a world that looked at faces. The boss did this because an ordinary person who had no other choice was forced to do so.
With this thought, Su Yun felt relieved.
"I remember now. Fabry's disease is caused by the inability to metabolize trihexyl glycosylceramide, which acc.u.mulates in the lysosomal body, leading to all kinds of clinical symptoms. It's inherited from the X chromosome, and it's more serious in males than females." Su Yun thought about it for a long time. Finally, he found traces of Fabry's disease in his memory and asked, "Boss, is treatment for this disease effective?"
"I don't know either. I've never seen it before," Zheng Ren said. "I read in a magazine that the cost of enzyme replacement treatment shouldn't be too expensive."
"That's too tragic. Such a young child." Chang Yue was overflowing with sympathy.
"You can just interpret it as diabetes. Injecting insulin every day doesn't affect anything. Moreover, it's better than diabetes. At the very least, you don't have to control your diet." Zheng Ren explained from a different angle.
When she said that she did not have to control her diet, Xie Yiren nodded repeatedly.
In her opinion, if she could not eat a lot of things, the world would be really tragic.
Turning around the corner of the Emergency Department, she could not see the crowd of troublemakers in the Emergency Department. She suddenly felt that she had returned to a normal world that was much quieter.
"They caused trouble at the 912. These people are really bold," Su Yun complained.
"It's very normal. A few days ago, when you guys weren't around, the family members of the patients directly went to the Inpatient Department and said that there were still empty beds here. Why didn't they let them stay at the hospital?" Chang Yue said. "The nurse told him that those beds were reserved for soldiers."
"Then, the patient's family started to make a scene?"
"It wasn't really a scene. Anyway, they said a lot of things." Chang Yue said. "I was too lazy to listen, so I left."
Chapter 798 - Hospital Consultation
After returning to the department, Zheng Ren and Su Yun changed their clothes and walked around the ward first.
Six beds... Compared to Sea City General Hospital, they were much shabbier.
Zheng Ren suddenly had a thought. If he returned to Sea City, the entire emergency building would be renovated, and there would be at least a hundred beds. If he worked hard every day to perform 20 TIPS surgeries a day, it would be 600 a month. A few months would be enough.
However, this was just a thought. Zheng Ren did not take it seriously. If he really went back to Sea City, how could there be such a large number of patients?
The deputy director of the Second People's Hospital bragged that there were as many patients as he wanted. However, after doing it a few times, the patients could not keep up.
The patients in the ward were very stable after the surgery. Their symptoms had already made a preliminary improvement.
Professor Rudolf Wagner was focused on organizing the relevant doc.u.ments and information. Zheng Ren went to look through the doc.u.ments and felt that he was like the foolish son of a landlord.
However, with the professor and Su Yun handling these matters, he felt much more comfortable. If they were all depending on him to do it, the sky would fall.
However, Zheng Ren's mind was filled with the scene of the Emergency Department causing trouble, and he could not get rid of it.
Zheng Ren felt a sense of sorrow. He sympathized with the Emergency Department's pediatrician and nurse staff for their unexpected disaster.
As he was thinking, his phone vibrated--the ringtone was very low.
He took it out and saw that it was Chief Qi from the Ultrasound Department.
"Boss Zheng, are you in the department?" Chief Qi answered the call and asked directly.
"Chief Qi, I'm here."
"Genitourinary surgery, conference room, and the entire hospital's here for consultation. Are you here to take a look?" Chief Qi said.
"Okay, I'll go up now."
After he finished speaking, the call had already hung up.
The department's chief was an authoritative figure.
Whether it was Concorde, 912, Peking University's First, Second, and Third departments, or the Eastern and Western hospitals, there were countless god-level figures in the Imperial Capital.
Every department's chief was able to reach the top successfully. Their own skill level was naturally very high, and they had countless helpers behind them.
To be able to obtain the approval of any chief was considered to have reached the sky in one step. It was just like how Zheng Ren could get Director Kong's approval and be transferred to 912. The moment he arrived, he received the treatment of a group of professors and was given six beds.
'Chief Qi treats me quite well. It'll be easier for me to gain a reputation during the consultation of the entire hospital,' Zheng Ren thought.
'Hurry up and go. I don't know what illness the consultation of the entire hospital is.'
'Genitourinary surgery... I'm really not very familiar with that.'
During the trainee for patients with liver hydatidosis, he clicked on an intermediate skill book to improve his surgical skills on the Department of Genitourinary Surgery.
However, this was not enough.
Zheng Ren did not think that he could say anything during the consultation of the entire hospital in the Department of Genitourinary Surgery. He reckoned that it was Chief Qi's guidance that allowed him to show his face in front of all the chief physicians and the professors in charge of the household.
This was a great favor, and Zheng Ren knew it.
Without wasting any time, Zheng Ren took the elevator and went straight to the Department of Genitourinary Surgery. Su Yun did not follow him. If he brought his assistant at this time, how arrogant would he be? He was afraid that if he went in, he would be despised by all the chief physicians.
At the entrance of the surgical demonstration classroom of the Department of Genitourinary Surgery, Zheng Ren gently knocked on the door, then pushed the door open and entered.
More than a dozen people were sitting in the room. In front of them was a projector with the patient's information on it.
Seeing Zheng Ren enter, Chief Qi and Chief Miao of the Department of Genitourinary Surgery waved at him at the same time.
Zheng Ren was stunned for a moment. Then, he bowed slightly to Chief Miao and sat down next to Chief Qi.
He had just entered, and he already had such a difficult multiple choice question?
What was the meaning of this? Zheng Ren was in a daze.
"This is the medical record. Take a look first," Chief Qi said. "If you know a little bit, say a few words. If you're not, just watch from here."
Zheng Ren understood the meaning and nodded.
The patient was a 23-year-old female patient. Because she did not menstruate, she was infertile and came to Imperial Capital to see a doctor. In the end, she discovered an adrenal tumor.
As soon as the opening chapter began, Zheng Ren was drawn by the special case.
A 23-year-old who had never had menstruation before knew how to treat a disease? How sloppy was that?
After taking a closer look, Zheng Ren realized that the patient was a woman from another city. She had not been pregnant since she got married. She came to Imperial Capital to see a doctor, and only then did she know that she had never had menstruation.
Abdominal Color Doppler imaging revealed that the right adrenal region was an echo tumor. The size was about 6.5cm by 6.4cm.
Abdominal contrast-enhanced CT scan revealed a mass of low-density of the right adrenal area, about 6.54 cm in size. Contrast-enhanced CT scan revealed that there were many blood vessels in the lesion, and the venous phase was quickly cleared. Adrenal tumors were considered.
Various test sheets were also relatively complete. Testosterone, androstenedione, dehydroepiandrosterone sul
fate, blood cortisol, and adrenocorticotropic hormone were all on the high side.
This should be a disease for the Department of Endocrinology, but there was an adrenal tumor, so they came to the Department of genitourinary Surgery to be hospitalized and prepared for excision.
This kind of relatively complicated disease was different from simple trauma.
Zheng Ren had some understanding of Chief Miao of the Department of Genitourinary Surgery. His surgical techniques were quite good.
A kidney invaded by cancer could almost perfectly be excised, and the hydatid vesicles were stripped clean. This level was already very high. Using the System's judgment, it was at least at the Grandmaster level.
However, the patient's disease was not that simple.
One had to know that the position occupied was the adrenal gland.
Zheng Ren had encountered patients with liver cancer accompanied by adrenal metastasis. During the operation, the adrenal gland metastasis was embolized, and the patient's blood pressure suddenly dropped.
After touching this endocrine organ, there would be unexpected changes.
This was especially so for this woman whose condition was very complicated. It was not something that could be simply removed by excising the adrenal tumor.
Zheng Ren looked at the medical record and gradually became stunned.
At this moment, the doctor from the Endocrinology Department was giving his opinion. He were in his forties or fifties. His speech was very melodious.
Zheng Ren read the medical record while listening. What he meant was to consider the possibility that the tumor on the right adrenal gland was a cortical source, with the exception of adrenal cortical carcinoma.
The patient's cortisol level was currently elevated. During the perioperative period, he should closely monitor the changes in vital signs, electrolytes, and mental state, and also give her glucocorticoid supplementation therapy.
He followed the rules, and there was nothing wrong with the treatment and judgment.
"Little Zheng, can you find the problem?" Chief Qi asked in a low voice.
Zheng Ren asked, "Is there a physical examination in gynecology?"
The Surgeon's Studio c1-799 Page 378
