Chapter 928 - Hepatolenticular Degeneration?
Chapter 928: Hepatolenticular Degeneration?
Chief Zhou did not think that Zheng Ren was making a mountain out of a molehill.
With Chief Kong’s connections, Boss Zheng would definitely not slap Zhu Liangchen in the face for no reason. If he were ten years younger, he might have been attacked head-on if he had been arrogant.
Moreover, the patients just now were all fine. What should have been sent to the stage had also been sent up. Why was there a problem at this time?
Looking at Zhu Liangchen’s appearance, he probably had the same thought as himself and thought that there was nothing wrong.
That was strange.
Soon, Zheng Ren and Zhu Liangchen walked back.
“Professor Zhu, I suggest that this surgery be postponed,” Zheng Ren said. “I’ve seen the radiographic films of the head and have some doubts. I want to check a few more tests to confirm the diagnosis before performing the surgery.”
“Boss Zheng, what do you think is the illness?” Zhu Liangchen was a little unhappy.
Deny the diagnosis? This was a standard face-smacking gesture.
The most fatal attack between doctors was that he also knew how to treat patients?
Zhu Liangchen looked at Zheng Ren, and the expression on his face became colder and colder.
“The patient’s head CT shows bilateral low-density symmetrical lenticular nuclei. This image is relatively faint, and it’s easy to ignore. On the CT, it’s considered a false image.” Zheng Ren inserted the radiographic films into the radiographic film viewer.
He clicked on the CT film. “The head MRI is more specific than CT. It shows the legume nucleus, caudate nucleus, midbrain and pons, thalamus, cerebellum and frontal cortex T1-weighted low-signal and T2-weighted high signal. Or the putamen nucleus and caudate nucleus show high and low mixed signal on T2-weighted image. There are also varying degrees of sulcus widening, ventricle enlargement, and so on.”
After that, Zheng Ren continued, “I believe that the patient has a rare hepatolenticular degeneration. I suggest that you check for biochemical tests related to copper metabolism, serum ceruloplasmin, urine copper, and liver copper.”
These tests were relatively unpopular. Places like Sea City did not have them at all. They might not have heard of them.
However, the Imperial Capital’s Hepatobiliary Hospital was a specialized hospital. These tests should have been done.
Hepatolenticular degeneration?
Zhu Liangchen and Chief Zhou were stunned for a moment, and then they began to recall this extremely rare disease.
This disease was because too much free copper in the serum was deposited in the liver, resulting in lobular cirrhosis.
When the lysosomes of the liver cells could not accommodate it, copper was dispersed and deposited into various organs through the blood. The neurons in the basal ganglia and their normal enzyme transport were particularly sensitive to the toxicity of inorganic copper, and the deposition of copper in the cerebral cortex and the dentate nucleus of the cerebellum also caused symptoms.
The damage of copper to the proximal tubule of the kidney could cause the loss of amino acids, proteins, calcium, and phosphates. Moreover, the deposition of free copper in the corneal elastic layer produced K-F rings.
At the same time, cirrhosis could produce a series of changes in portal hypertension.
If it was diagnosed as hepatolenticular degeneration… Chief Zhou smiled.
Things were getting more and more interesting.
Zhu Liangchen’s luck was not very good. The incidence of this disease was usually only one in 100,000.
He even had to receive it from him and then ask Boss Zheng to operate on him.
This luck was really out of this world.
Zhu Liangchen was a little embarrassed, and his face instantly drooped.
This was because the ‘Professor’ had stopped the surgery… In the past, only he had stopped other people’s surgeries, but no one had stopped their own surgeries!
“The patient’s expression is strange, his speech is unclear, and his muscles are spasming. However, it’s not like the rhythmic spasms of Parkinson’s disease.” Zheng Ren did not care about Zhu Liangchen’s displeasure. He told the truth. “Let’s stop this surgery. First, let’s make a clear diagnosis. If the diagnosis is correct, then give the patient some D-penicillamine for a period of time. After the symptoms have subsided, we can do it at any time.”
Su Yun frowned as he watched from the side.
If they were to run freelance surgeries in the Imperial Capital, not only would they not earn money, but they would also have to be very careful with every step.
They were all big shots in the industry. Even if their skill level was slightly lower, they would not be able to handle a wide range of people. This was a completely different concept compared to running freelance surgeries in other cities.
What would Chief Kong think if Zhu Liangchen’s reputation was tarnished?
However, there was nothing wrong with what Zheng Ren said. If it really was hepatolenticular degeneration, the patient’s copper metabolism would be problematic if TIPS surgery was performed directly.
Sigh, he was really unlucky to have encountered such a situation.
Zhu Liangchen was silent for a few seconds, but he still nodded and said, “Then let’s stop this patient’s surgery.”
The air in the office instantly became lighter.
The remaining two patients quickly finished reading the film. Zhu Liangchen’s face was gloomy. He arranged for someone to communicate with the patient’s family and then brought Zheng Ren to the surgery.
The atmosphere was not as harmonious as it was when they first arrived.
Su Yun wanted to pull aside Zheng Ren to ask about the situation, but Zhu Liangchen was always by his side. He never found an opportunity.
When they arrived at the operating theater, Hu Yanhui had already prepared the equipment for the live broadcast of the surgery and was waiting.
The sequence of the surgery did not consider the live broadcast of the surgery. Instead, it was arranged according to the age of the patient.
Because the surgery required fasting water, the older ones were placed at the front. Zheng Ren also recognized this.
He went to change into his lead clothes and began to scrub his hands. Su Yun finally seized the opportunity. He pulled Zheng Ren and asked, “Boss, is the diagnosis clear for hepatolenticular degeneration?”
“Huh?” Zheng Ren was stunned for a moment. Then, he smiled and said, “It’s clear. It’s not to give Zhu any face. If this patient had undergone surgery, the venous blood would not flow in the liver. Without the filtration of the toxin, it’s very likely that he would have symptoms of acute copper poisoning.”
Su Yun nodded. As long as he was sure, there was nothing more to say.
Taking care of Zhu Liangchen’s face, the one who was slapped in the end was still Zheng Ren. However, he was a little puzzled and asked in a low voice, “Have you ever seen patients with hepatolenticular degeneration?”
“No.”
“Then how did you diagnose them?” Su Yun asked.
By right, the chief directors of the Imperial Capital saw 180 patients a day, and there were plenty of difficult and complicated diseases. If it was a competition of talent, Zheng Ren might be stronger than everyone else. But if it was a competition of experience, he might be a little weaker.
This was what Su Yun had been worried about all along.
But… Today’s incident made him feel that his worldview was once again forced in another direction by Zheng Ren.
“I’m reading. Shouldn’t I write down all the diseases related to the liver and compare them one by one?” Zheng Ren said to Su Yun in surprise. “Isn’t that how you treat patients?”
“…” Su Yun really wanted to beat Zheng Ren up.
There were at least 800 cases of liver diseases that did not amount to 1,000. Who could remember every single one of them? And he had to go through every single patient?
This guy was really not human.
“I’m going on stage. Which channel is the live broadcast on?”
“Channel three and channel six,” Su Yun said expressionlessly.
“Oh, contact Chief Kong and see when Chief Kong and Professor Pei will arrive,” Zheng Ren said.
“Are you afraid that they won’t be able to arrive after you’re done?” Su Yun was getting impatient.
“Yes,” Zheng Ren said frankly.