After watching the previous film, the patient's diagnosis was very clear, and it was primary liver cancer.

There is a 3x4cm lesion on the liver, and the gallbladder is intact. Not to mention stones, the gallbladder wall is not even rough.

Moreover, what Zhao Wenhua inserted was not one front film, but two.

The first one is a preoperative film, and there is no iodine oil in the lesion. The second one is after embolization, and the date should be the surgery that was performed a few days ago.

In recent films, the tumor has been necrotic and the needle can still be seen. It should be that radiofrequency ablation was performed after embolization.

"It shouldn't be gallstones." Zheng Ren said affirmatively.

After watching the movie, he knew where Zhao Wenhua was confused.

Zhao Wenhua nodded repeatedly, "Boss Zheng, there are no gallbladder stones before the operation. In just a few days, it is impossible for a large number of silt-like gallstones to appear. This is a conventional logical judgment, but it is found in imaging."

As he said that, he sighed helplessly.

Sometimes there will be errors in image and logical judgments, and most doctors will use objective image judgments as the final basis.

After all, images exist objectively, otherwise what is the significance of performing imaging examinations on patients? In many cases, thinking logic is limited by the quality and level of the doctor themselves.

But at Zhao Wenhua's level, objective images can only be used as one of the criteria for reference, and he will not believe in any objective images.

The higher the doctor's level, the more problems you will consider.

Every logically unsolvable problem may occur very rare situations, causing the patient's condition to further worsen and even causing the patient to die.

Even if there are typical imaging diagnosis on the film, you have to figure it out.

This is also because Zhao Wenhua was stunned when he saw the ct film with a very "clear diagnosis".

Because he could only feel something was wrong, but he could not overturn the diagnosis of gallbladder stones. The two were inconsistent and made people unable to do so.

"What about other tests?" Zheng Ren said.

Lin Yuan sat aside and was writing medical records. She was a little sleepy, but after hearing what Boss Zheng said, she became energetic.

This is the tone of the superior doctor's speech. As the young doctor at the bottom of Boss Zheng's medical team, he must have gone over and handed the other tests he needed to his hands.

This was the case when I was at Harvard, and the same was true when I returned to 912.

However, Lin Yuan was shocked the next second.

She saw Zhao Wenhua, one of the professors in the 912 interventional department, bowed her waist slightly, ran to the computer, and easily printed out all the patient's examination reports.

The printer was buzzing, and a4 paper spit out every page.

Lin Yuan looked at Zhao Wenhua in surprise. Seeing that he looked anxious, he would take it directly to his hands every time the printer spit out a report sheet.

As for it!

Although Boss Zheng is not willing to joke, it is painful to knock on the radial styloid process with hemostasis forceps on the operating table, he is still very kind.

Lin Yuan didn't understand why Professor Zhao Wenhua and Professor Zhao showed such a humble attitude. He was simply... he looked like a young doctor than himself.

"Boss Zheng, look." Zhao Wenhua immediately took the problematic test form in his hand and blew it off, so that the temperature of the printer staying on the a4 paper was reduced a little.

Sure enough, the patients had high white blood cells, high hematuria amylase, and increased serum lipase.

Blood calcium decreases, blood sugar increases...

Zhao Wenhua is experienced and has done all the tests he should do, and Zheng Ren has nothing to picky about.

"Does the patient have a history of diabetes?" Zheng Ren asked.

"No." Zhao Wenhua answered immediately.

Without a history of diabetes, blood sugar is increased and blood calcium is reduced, which is one of the clinical tests for typical acute pancreatitis.

Could it be the postoperative stress reaction that leads to cholecystitis and acute pancreatitis? Zheng Ren looked through the test sheet and thought to himself.

Although he thought so, he did not draw a simple and rough conclusion.

The patient's test form and imaging examination are very clear - acute gallbladder stones and acute pancreatitis.

But!

There is still no way to explain how so many silt and sand-like stones came about.

If it were the cholecystitis with rough gallbladder walls, Zheng Ren would probably give up thinking about it again at this time. However, a large number of mud and sand-like stones appeared in the gallbladder in a few days. Whatever you think is wrong.

Moreover, it is a postoperative patient. Even if he eats irregularly, his family is taking good care of him at this time. If he can eat, he can settle down.

eccentric.

Zhao Wenhua looked at Zheng Ren and was quite expectant.

"Tell me about the patient's condition." Zheng Ren stood in the position of reading the film, holding his arms and chin, watching the film seriously, and said lightly.

The young doctor in Zhao Wenhua's group was about to speak when he was interrupted by Zhao Wenhua.

"That's right, Boss Zheng." Zhao Wenhua began to report his medical history like a subordinate doctor.

"The patient came to our hospital for treatment a week ago and was initially diagnosed with liver cancer. When I went out of the clinic, I took the patient in. He underwent interventional embolization treatment + radiofrequency ablation 3 days ago. There is a film, which is the image left after interventional embolization."

Zheng Ren nodded and signaled that he knew.

"The patient recovered well after the operation. He suddenly complained about severe abdominal pain in the early morning. He urgently checked the CT and found gallbladder stones and pancreatitis. After consultation, the same was true for hepatobiliary surgery diagnosis, and symptomatic treatment is recommended."

"But I think there is something wrong with watching the movie." Zhao Wenhua was very cautious. "The patient is not in good condition now and the pain has not been relieved."

"Have you given painkillers?"

"I didn't give it to you, and I haven't figured out some things yet."

Zheng Ren nodded.

If you don’t understand, give painkillers, that is to make you die.

No! I just read the test form and seemed to have some problems. I passed by myself and didn't pay much attention.

Zheng Ren picked up the test form again in confusion and looked at it one by one.

Soon, he discovered the problem. The patient's blood was high in high blood cells, which can be used as one of the auxiliary diagnostic evidence for cholecystitis and acute pancreatitis.

However, the patient's hemoglobin has dropped to 76g/l, while the hemoglobin before the operation is normal.

"Anemia? Professor Zhao, what did you think about it?" Zheng Ren asked.

Zhao Wenhua shook his head in a daze.

Neither radiofrequency ablation nor interventional embolization surgery will cause anemia.

I won’t talk about interventional embolism. There is a needle hole on the femoral artery of the thigh, then the guide wire and catheter enter, and embolization treatment is carried out inside the blood vessel. There are few complications of bleeding, because embolism itself is one of the hemostatic treatments.

If radiofrequency ablation is not thick, the radiofrequency needle is not thick and penetrates into the liver. When it is extracted after ablation, the radiofrequency needle must be heated to avoid needle transfer.

While killing tumor cells, the punctured needle can also be "scalded". Even if capillary bleeding is bleeding, it will be like an electric burn, and the bleeding will stop.

There was no anemia before the operation, nor was there the first re-examination after the operation. Progressive anemia only occurred in the early morning.
Chapter completed!