Chapter 2150： Coquettish operation
Feng Xuhui was shocked by Su Yun’s words.
Is the diagnosis not clear? Although not a doctor, the adrenal crisis Feng Xuhui is aware. The disease is very heavy and very urgent, and this is certain. It is undeniable that the medical academy can have a high level of medical care. People should be no risk.
Yun Yuner said that things are getting bigger!
"It seems reasonable to diagnose, renal vein thrombosis leads to adrenal crisis. There is even a hematoma caused by bleeding. This is simply too coincidentally, just like a little boy with a right lower quadrant pain diagnosis of acute appendicitis, there is nothing to think about."
Feng Xuhui looked at Su Yun with amazement. He said that the patient's medical history, symptoms, objective examination, final diagnosis, and so on, he could not insert a word.
"It's okay to do this kind of thing. Once something happens, that's a big deal."
"For example?"
"For example, renal vein thrombosis can be said to be caused by oral contraceptives. This patient, we have done it, that is, the doctor of the medical university, the one who fell." Su Yun said than the stroke.
While explaining the condition with Feng Xuhui, Su Yun is sorting out his ideas.
Feng Xuhui was impressed by this operation. Zheng Boss took out a 12cm large thrombus, and he still remembers it.
"But it's too coincidental, but I feel that my heart is not practical." Su Yun smiled.
Yun Geer’s judgment is too ideological. Feng Xuhui did not believe that he still felt that the adrenal crisis was enough.
"The patient has repeated erectic syncope in 7 days, hyponatremia, clear diagnosis of adrenal crisis, and hypotension is the main cause of syncope." Su Yun casually groaned. "Well, hyponatremia is what you said, and Not very obvious, this diagnosis is not for the time being."
"Adrenal insufficiency leads to adrenal crisis, and common causes of primary adrenal insufficiency include adrenal tuberculosis, fungal infections, solid tumors, and autoimmune diseases."
"I estimate that the side of the hospital affiliated hospital should also be checked one by one."
When Su Yunqi came here, he would not say it anymore. It would be meaningless to say it, and it was a waste of saliva.
All, wait until you see a limited test result.
Zheng Renhe and his surgery are not very fast. Because the professor is leaving, Zheng Ren is extraordinarily serious, and every problematic step must be corrected repeatedly.
After the operation was completed, Zheng Ren walked out of the operating room, and various materials from Lin Yuan were also passed over.
Su Yun put Lin Yuan into the group. At the moment of entering the group, Chu Xiaoran’s head flashed.
A series of welcome words let Lin Yuan feel that looking for his own father to do things this time, absolutely worth the money.
Only when you enter the group, you are considered to be your own.
She took the time to upload the information, and then looked at Gu Xiaoying to pick up the patient and brush the next operation.
"The problem of blood tests is not big," Su Yun and Zheng Ren said.
"Cortisol 0.74μg/dl, ACTH356PG/ml, normal thyroid function; RAAS showed plasma renin activity 3.29ng/(ml·h), aldosterone <59pg/ml; standing RAAS showed PRA6.37ng/(ml· h), ALD78.1pg/ml."
He picked up the problem and said that Zheng Ren just nodded and looked musing.
In addition, the results of abdominal enhanced CT showed the same as those predicted by Zheng Ren and Su Yun—the bilateral adrenal glands had enlarged swelling, and the left and right sides were 3.2 cm×3.4 cm and 2.5 cm×4.9 cm, respectively. The density is uneven.
The CT value was 36~65HU, and the enhanced scan was not clearly enhanced, and the possibility of adrenal hematoma was large.
The left renal vein was dilated, and an irregular low-density lesion was seen in the lumen. The length was about 2.3 cm. A low-density plaque was also seen in the right renal vein, and the length was about 0.8 cm.
"Boss, see the problem?" Su Yun saw Zheng Ren not talking, then asked.
"There are cases in the case that the patient has pigmentation." Zheng Rendao.
The examination of the Affiliated Hospital of the Medical University is very detailed. It describes the upper sternal fossa, armpits, waist and abdomen, auricles and palm prints, skin pigmentation on the dorsal side of the index finger, pigmentation of the lips and oral mucosa.
The left alar can be seen scattered in herpes. Pigmentation of the double jaw skin, visible in the papules, partial surface ulceration.
These are not described by Feng Xuhui.
"I saw, tuberculosis is not considered, adrenal fungal infection..."
"Do not consider." Zheng Ren said affirmatively.
"Adrenal tumors have also been ruled out, and that is probably the disease of the autoimmune system." Su Yun said with a smile. "You should look for a big white to see."
"No need, illness... I think again." Zheng Rendao.
"The exclusion can be ruled out, I guess it is antiphospholipid syndrome."
"Well, secondary." Zheng Ren added a sentence.
"What is the idea of treatment?"
Zheng Ren thought for a moment and began to discuss with Su Yun.
This time is a very professional conversation, Feng Xuhui could not keep up from the beginning.
In the dialogue between Zheng Ren and Su Yun, every term must be pondered for a long time. Before I even wanted to understand the content of the first sentence, Zheng and Yun Geer had already said the tenth sentence.
Forget it, Feng Xuhui gave up his mind to understand this matter, and finally Zheng and Yun Yuner gave an answer.
Just looking at the two people to discuss the condition, it is still very interesting.
Mr. Zheng is still the general manager of Haicheng. He is honest and honest. He speaks a word and looks at it like a coveted old professor. Yun Geer hasn't changed much. Three or five sentences don't mean Zheng Zong, and he is uncomfortable.
The two, like quarrels, said that for nearly half an hour, the Xie people were used to it. They didn't listen to what they were saying, and they kept staring at the surgery inside.
At the end of the operation, the two are still quarreling and listening to the meaning. They are speculating on possible tests that have not been returned according to the results of the existing tests.
This is the operation of non-humans. Feng Xuhui is a bit stunned. Is this correct?
At the end of the operation, Zheng also explained the operation to Fu Guier through the interval between the two. And Yun Geer found the pen and paper and started to write things.
Facing the coquettish operation of Su Yun Feng Xuhui has no idea what he is doing.
In this way, time in Zheng Ren and Su Yun arguing about the disease and the speed of the surgery.
After the last operation was completed, Su Yun took a piece of paper and smiled and said: "That's it, the diagnosis is secondary antiphospholipid syndrome."
"Ok."
"Secondary antiphospholipid syndrome, the possibility of systemic lupus erythematosus, bilateral adrenal venous thrombosis followed by adrenal hematoma; primary adrenal insufficiency; adrenal crisis."
Su Yun said while writing, the black hair floating in front of the forehead, like a very proud.
When Su Yun was finished, Zheng Ren took a look and added a smile at the end.
"The boss said that it is useless to do this."
"Get used to it." Zheng Ren smiled and handed over a dozen sheets of A4 paper to Feng Xuhui.
Is the diagnosis not clear? Although not a doctor, the adrenal crisis Feng Xuhui is aware. The disease is very heavy and very urgent, and this is certain. It is undeniable that the medical academy can have a high level of medical care. People should be no risk.
Yun Yuner said that things are getting bigger!
"It seems reasonable to diagnose, renal vein thrombosis leads to adrenal crisis. There is even a hematoma caused by bleeding. This is simply too coincidentally, just like a little boy with a right lower quadrant pain diagnosis of acute appendicitis, there is nothing to think about."
Feng Xuhui looked at Su Yun with amazement. He said that the patient's medical history, symptoms, objective examination, final diagnosis, and so on, he could not insert a word.
"It's okay to do this kind of thing. Once something happens, that's a big deal."
"For example?"
"For example, renal vein thrombosis can be said to be caused by oral contraceptives. This patient, we have done it, that is, the doctor of the medical university, the one who fell." Su Yun said than the stroke.
While explaining the condition with Feng Xuhui, Su Yun is sorting out his ideas.
Feng Xuhui was impressed by this operation. Zheng Boss took out a 12cm large thrombus, and he still remembers it.
"But it's too coincidental, but I feel that my heart is not practical." Su Yun smiled.
Yun Geer’s judgment is too ideological. Feng Xuhui did not believe that he still felt that the adrenal crisis was enough.
"The patient has repeated erectic syncope in 7 days, hyponatremia, clear diagnosis of adrenal crisis, and hypotension is the main cause of syncope." Su Yun casually groaned. "Well, hyponatremia is what you said, and Not very obvious, this diagnosis is not for the time being."
"Adrenal insufficiency leads to adrenal crisis, and common causes of primary adrenal insufficiency include adrenal tuberculosis, fungal infections, solid tumors, and autoimmune diseases."
"I estimate that the side of the hospital affiliated hospital should also be checked one by one."
When Su Yunqi came here, he would not say it anymore. It would be meaningless to say it, and it was a waste of saliva.
All, wait until you see a limited test result.
Zheng Renhe and his surgery are not very fast. Because the professor is leaving, Zheng Ren is extraordinarily serious, and every problematic step must be corrected repeatedly.
After the operation was completed, Zheng Ren walked out of the operating room, and various materials from Lin Yuan were also passed over.
Su Yun put Lin Yuan into the group. At the moment of entering the group, Chu Xiaoran’s head flashed.
A series of welcome words let Lin Yuan feel that looking for his own father to do things this time, absolutely worth the money.
Only when you enter the group, you are considered to be your own.
She took the time to upload the information, and then looked at Gu Xiaoying to pick up the patient and brush the next operation.
"The problem of blood tests is not big," Su Yun and Zheng Ren said.
"Cortisol 0.74μg/dl, ACTH356PG/ml, normal thyroid function; RAAS showed plasma renin activity 3.29ng/(ml·h), aldosterone <59pg/ml; standing RAAS showed PRA6.37ng/(ml· h), ALD78.1pg/ml."
He picked up the problem and said that Zheng Ren just nodded and looked musing.
In addition, the results of abdominal enhanced CT showed the same as those predicted by Zheng Ren and Su Yun—the bilateral adrenal glands had enlarged swelling, and the left and right sides were 3.2 cm×3.4 cm and 2.5 cm×4.9 cm, respectively. The density is uneven.
The CT value was 36~65HU, and the enhanced scan was not clearly enhanced, and the possibility of adrenal hematoma was large.
The left renal vein was dilated, and an irregular low-density lesion was seen in the lumen. The length was about 2.3 cm. A low-density plaque was also seen in the right renal vein, and the length was about 0.8 cm.
"Boss, see the problem?" Su Yun saw Zheng Ren not talking, then asked.
"There are cases in the case that the patient has pigmentation." Zheng Rendao.
The examination of the Affiliated Hospital of the Medical University is very detailed. It describes the upper sternal fossa, armpits, waist and abdomen, auricles and palm prints, skin pigmentation on the dorsal side of the index finger, pigmentation of the lips and oral mucosa.
The left alar can be seen scattered in herpes. Pigmentation of the double jaw skin, visible in the papules, partial surface ulceration.
These are not described by Feng Xuhui.
"I saw, tuberculosis is not considered, adrenal fungal infection..."
"Do not consider." Zheng Ren said affirmatively.
"Adrenal tumors have also been ruled out, and that is probably the disease of the autoimmune system." Su Yun said with a smile. "You should look for a big white to see."
"No need, illness... I think again." Zheng Rendao.
"The exclusion can be ruled out, I guess it is antiphospholipid syndrome."
"Well, secondary." Zheng Ren added a sentence.
"What is the idea of treatment?"
Zheng Ren thought for a moment and began to discuss with Su Yun.
This time is a very professional conversation, Feng Xuhui could not keep up from the beginning.
In the dialogue between Zheng Ren and Su Yun, every term must be pondered for a long time. Before I even wanted to understand the content of the first sentence, Zheng and Yun Geer had already said the tenth sentence.
Forget it, Feng Xuhui gave up his mind to understand this matter, and finally Zheng and Yun Yuner gave an answer.
Just looking at the two people to discuss the condition, it is still very interesting.
Mr. Zheng is still the general manager of Haicheng. He is honest and honest. He speaks a word and looks at it like a coveted old professor. Yun Geer hasn't changed much. Three or five sentences don't mean Zheng Zong, and he is uncomfortable.
The two, like quarrels, said that for nearly half an hour, the Xie people were used to it. They didn't listen to what they were saying, and they kept staring at the surgery inside.
At the end of the operation, the two are still quarreling and listening to the meaning. They are speculating on possible tests that have not been returned according to the results of the existing tests.
This is the operation of non-humans. Feng Xuhui is a bit stunned. Is this correct?
At the end of the operation, Zheng also explained the operation to Fu Guier through the interval between the two. And Yun Geer found the pen and paper and started to write things.
Facing the coquettish operation of Su Yun Feng Xuhui has no idea what he is doing.
In this way, time in Zheng Ren and Su Yun arguing about the disease and the speed of the surgery.
After the last operation was completed, Su Yun took a piece of paper and smiled and said: "That's it, the diagnosis is secondary antiphospholipid syndrome."
"Ok."
"Secondary antiphospholipid syndrome, the possibility of systemic lupus erythematosus, bilateral adrenal venous thrombosis followed by adrenal hematoma; primary adrenal insufficiency; adrenal crisis."
Su Yun said while writing, the black hair floating in front of the forehead, like a very proud.
When Su Yun was finished, Zheng Ren took a look and added a smile at the end.
"The boss said that it is useless to do this."
"Get used to it." Zheng Ren smiled and handed over a dozen sheets of A4 paper to Feng Xuhui.
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