Chapter 785： Heterotopic spleen
On the film, the patient has no spleen.
If you stay in place, you can see a scar tissue.
"Well, it is estimated that I have done splenectomy." Zheng Ren then asked: "Who is the patient?"
"It's my lover." The middle-aged man answered cautiously.
“How many years ago did splenectomy be done?” Zheng Ren asked.
"Twenty-two years ago, I had a car accident and later splenectomy." The man replied immediately.
The general doctor looks at the film. The first question is about the splenectomy. It is not a mirror person, nothing special.
Zheng Ren continued to look at him, the professor stood behind his side, and also focused on reading.
I haven't watched the film with my boss for a long time. This feeling is really great.
A few minutes later, the professor said: "Boss, this liver cancer is a bit strange, how do I feel that it is not."
"Well, it's a bit strange, but it's not that liver cancer is hard to say." Zheng Ren held a sly and looked at the film and said: "I highly suspect that it is ectopic spleen planting, not liver cancer."
“Hey?” Professor Rudolf Wagner was surprised. “Boss, are you looking at it? Is this a bit of a vulture?”
Saying, the professor clicked on the location of a signal anomaly on the film.
"Not all, there is only a little signal abnormality. Rich, you pay attention, the patient has had an interventional embolization."
"I noticed." Professor Rudolf Wagner listened to Zheng Ren about the embolism, and seemed to think of something, staring at a few frames of the film to look carefully.
Zheng Ren did not continue to explain that for the level of reading of the professor, he said that it is enough.
The middle-aged man is puzzled.
Is it true that the liar should be said to be the heavier? But how can this young "doctor" say that it is not liver cancer?
What is ectopic?
Is it transferred?
In the doubts of the brain, his ears stood up and wanted to listen to the dialogue between Zheng Ren and Professor Rudolf Wagner.
But the two of them then silenced, did not say a word, began to "face" against the film.
A few minutes later, the professor made a fist in his right hand and hit it on the left palm, making a "beep" sound. This movement, Professor and Su Yunxue is full ten.
"Boss, I want to understand! It is indeed a spleen planting!" Professor Rudolf Wagner said happily.
"Well, the diagnosis is relatively clear. Especially after an interventional embolization treatment, it has been basically confirmed." Zheng Rendao.
After he finished, he took the film and put it in the pocket. He said, "Let's go find Teacher Yang. I will write it on paper for a while. This disease, Mr. Yang is doing a resection, postoperative pathology. Diagnosis is enough."
Said, Zheng Ren found an abandoned a4 paper, he made a few strokes on the front of the handwriting, indicating that it was invalid, and then wrote his own diagnosis and surgical advice on the back.
The family of the patient was stunned.
There are many kinds of words that Zheng Ren might say in his mind, and he has made an emergency plan for each.
If you are a liar, what should I do? He knows what to do.
However, this young "liar" actually sent himself back to general surgery.
Is it that I guessed it wrong?
Middle-aged man holding paper in his hand, carefully looking at the words above, wondering.
"Go, let me listen to Teacher Yang. Before you lover, you have abdominal pain all the year round. It is caused by spleen planting and backlog of the liver. No major event, it will be good." Zheng Ren said, take out the mobile phone.
He first left Professor Yang's mobile phone with a note and then dialed it out.
"Mr. Yang, the patient's film I finished reading."
"Uh……"
"Okay, okay. Yang Ge, the film is considered to be ectopic spleen planting, regardless of liver cancer."
"Yes, yes, your judgment is correct. If you have a bed, you can go to the hospital, do a resection, pathology... you can see the spleen tissue during the incision."
"Oh, yes, the family of the patient is here. I am taking it up..."
"Yes, then I am waiting for you."
After that, Zheng Ren hangs up the phone.
"Mr. Yang... Yang Ge said that after a while, wait a minute, save it." Zheng Ren and the patient's family said.
The family members of the patient were so aggressive that the development of the matter was completely out of his expectations.
Soon, Professor Yang wore a isolation suit and a sterile cap and hurried to the intervention department.
"Zheng boss, I don't think it is liver cancer." After entering the door, Professor Yang hurriedly said.
It seems that his face has just stepped down, and even the clothes have not had time to change. It may even be an intermittent period of surgery, taking the time to run down.
"The probability of 90% is ectopic spleen planting." Zheng Ren nodded.
This kind of thing, Zheng Ren can not, nor dare to guarantee 100%. If the frozen ice during surgery is malignant, there is no way to explain it.
Under the premise of no pathological gold standard, Zheng Ren, the diagnosis of the big pig's hoof, must doubt it.
"Zheng boss, your level is really high." Professor Yang praised: "Give me a message, how do you see it."
Zheng Ren feels a little strange, an autologous liver transplant, Professor Yang is like this?
However, he saw Professor Yang concentrate on watching the film. It seemed to be a matter of heart, and he did not think much, and he smiled.
"You are not involved, so you don't know much about the intervention." Zheng Rendao: "The patient had an interventional embolization. You see here, after the embolization of the iodized oil, there are only embolic necrosis, but typical The liver cancer lesions did not appear on the image."
"Few liver cancers present this image. Coupled with the patient's medical history, intermittent abdominal pain for many years, 22 years ago, there is a history of splenectomy, so I judge the possibility of ectopic spleen planting is relatively large."
Professor Yang looked at the film, and Zheng Ren’s words solved several of his questions but the reason is not very sufficient.
Zheng Ren’s words can deny liver cancer with a high probability, but spleen cultivation cannot be denied.
"Zheng boss, if the spleen grows..."
"The preoperative 64-row t-enhancement showed a uniform enhancement of the lesion in the arterial phase, while the venous phase was slightly enhanced. Angiography showed that the branch of the hepatic artery supplied this round-rich blood for the mass. At this time, it was suspected to be liver cancer. There is no mistake." Zheng Ren said, picking another film from the pocket.
"After postoperative review, the enhancement of nucleus magnetic arterial phase is not obvious, but the metastatic lesions on the abdominal wall are opposite." Zheng Rendao: "Because the blood vessels in the abdominal wall lesions are relatively thin, there is no embolization treatment, and this involves splenomegaly. The image after embolization is particularly similar."
Interventional embolization for splenomegaly cirrhosis can effectively increase the values of white blood cells and platelets.
Although Zheng Ren has not done it, but the interventional surgery is close to the peak, this "small surgery" is well known.
"So, I have a high probability to confirm that the local doctor has done a splenic embolization operation." Zheng Ren smiled.
If you stay in place, you can see a scar tissue.
"Well, it is estimated that I have done splenectomy." Zheng Ren then asked: "Who is the patient?"
"It's my lover." The middle-aged man answered cautiously.
“How many years ago did splenectomy be done?” Zheng Ren asked.
"Twenty-two years ago, I had a car accident and later splenectomy." The man replied immediately.
The general doctor looks at the film. The first question is about the splenectomy. It is not a mirror person, nothing special.
Zheng Ren continued to look at him, the professor stood behind his side, and also focused on reading.
I haven't watched the film with my boss for a long time. This feeling is really great.
A few minutes later, the professor said: "Boss, this liver cancer is a bit strange, how do I feel that it is not."
"Well, it's a bit strange, but it's not that liver cancer is hard to say." Zheng Ren held a sly and looked at the film and said: "I highly suspect that it is ectopic spleen planting, not liver cancer."
“Hey?” Professor Rudolf Wagner was surprised. “Boss, are you looking at it? Is this a bit of a vulture?”
Saying, the professor clicked on the location of a signal anomaly on the film.
"Not all, there is only a little signal abnormality. Rich, you pay attention, the patient has had an interventional embolization."
"I noticed." Professor Rudolf Wagner listened to Zheng Ren about the embolism, and seemed to think of something, staring at a few frames of the film to look carefully.
Zheng Ren did not continue to explain that for the level of reading of the professor, he said that it is enough.
The middle-aged man is puzzled.
Is it true that the liar should be said to be the heavier? But how can this young "doctor" say that it is not liver cancer?
What is ectopic?
Is it transferred?
In the doubts of the brain, his ears stood up and wanted to listen to the dialogue between Zheng Ren and Professor Rudolf Wagner.
But the two of them then silenced, did not say a word, began to "face" against the film.
A few minutes later, the professor made a fist in his right hand and hit it on the left palm, making a "beep" sound. This movement, Professor and Su Yunxue is full ten.
"Boss, I want to understand! It is indeed a spleen planting!" Professor Rudolf Wagner said happily.
"Well, the diagnosis is relatively clear. Especially after an interventional embolization treatment, it has been basically confirmed." Zheng Rendao.
After he finished, he took the film and put it in the pocket. He said, "Let's go find Teacher Yang. I will write it on paper for a while. This disease, Mr. Yang is doing a resection, postoperative pathology. Diagnosis is enough."
Said, Zheng Ren found an abandoned a4 paper, he made a few strokes on the front of the handwriting, indicating that it was invalid, and then wrote his own diagnosis and surgical advice on the back.
The family of the patient was stunned.
There are many kinds of words that Zheng Ren might say in his mind, and he has made an emergency plan for each.
If you are a liar, what should I do? He knows what to do.
However, this young "liar" actually sent himself back to general surgery.
Is it that I guessed it wrong?
Middle-aged man holding paper in his hand, carefully looking at the words above, wondering.
"Go, let me listen to Teacher Yang. Before you lover, you have abdominal pain all the year round. It is caused by spleen planting and backlog of the liver. No major event, it will be good." Zheng Ren said, take out the mobile phone.
He first left Professor Yang's mobile phone with a note and then dialed it out.
"Mr. Yang, the patient's film I finished reading."
"Uh……"
"Okay, okay. Yang Ge, the film is considered to be ectopic spleen planting, regardless of liver cancer."
"Yes, yes, your judgment is correct. If you have a bed, you can go to the hospital, do a resection, pathology... you can see the spleen tissue during the incision."
"Oh, yes, the family of the patient is here. I am taking it up..."
"Yes, then I am waiting for you."
After that, Zheng Ren hangs up the phone.
"Mr. Yang... Yang Ge said that after a while, wait a minute, save it." Zheng Ren and the patient's family said.
The family members of the patient were so aggressive that the development of the matter was completely out of his expectations.
Soon, Professor Yang wore a isolation suit and a sterile cap and hurried to the intervention department.
"Zheng boss, I don't think it is liver cancer." After entering the door, Professor Yang hurriedly said.
It seems that his face has just stepped down, and even the clothes have not had time to change. It may even be an intermittent period of surgery, taking the time to run down.
"The probability of 90% is ectopic spleen planting." Zheng Ren nodded.
This kind of thing, Zheng Ren can not, nor dare to guarantee 100%. If the frozen ice during surgery is malignant, there is no way to explain it.
Under the premise of no pathological gold standard, Zheng Ren, the diagnosis of the big pig's hoof, must doubt it.
"Zheng boss, your level is really high." Professor Yang praised: "Give me a message, how do you see it."
Zheng Ren feels a little strange, an autologous liver transplant, Professor Yang is like this?
However, he saw Professor Yang concentrate on watching the film. It seemed to be a matter of heart, and he did not think much, and he smiled.
"You are not involved, so you don't know much about the intervention." Zheng Rendao: "The patient had an interventional embolization. You see here, after the embolization of the iodized oil, there are only embolic necrosis, but typical The liver cancer lesions did not appear on the image."
"Few liver cancers present this image. Coupled with the patient's medical history, intermittent abdominal pain for many years, 22 years ago, there is a history of splenectomy, so I judge the possibility of ectopic spleen planting is relatively large."
Professor Yang looked at the film, and Zheng Ren’s words solved several of his questions but the reason is not very sufficient.
Zheng Ren’s words can deny liver cancer with a high probability, but spleen cultivation cannot be denied.
"Zheng boss, if the spleen grows..."
"The preoperative 64-row t-enhancement showed a uniform enhancement of the lesion in the arterial phase, while the venous phase was slightly enhanced. Angiography showed that the branch of the hepatic artery supplied this round-rich blood for the mass. At this time, it was suspected to be liver cancer. There is no mistake." Zheng Ren said, picking another film from the pocket.
"After postoperative review, the enhancement of nucleus magnetic arterial phase is not obvious, but the metastatic lesions on the abdominal wall are opposite." Zheng Rendao: "Because the blood vessels in the abdominal wall lesions are relatively thin, there is no embolization treatment, and this involves splenomegaly. The image after embolization is particularly similar."
Interventional embolization for splenomegaly cirrhosis can effectively increase the values of white blood cells and platelets.
Although Zheng Ren has not done it, but the interventional surgery is close to the peak, this "small surgery" is well known.
"So, I have a high probability to confirm that the local doctor has done a splenic embolization operation." Zheng Ren smiled.
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