Chapter 784 Heterotopic Spleen Planting (Leader Cai Shu Ning Jiageng 4)

On the film, the patient has no spleen.

Left in place, a scar tissue can be vaguely seen.

"Well, it's probably a splenectomy." Zheng Ren then asked, "Who is the patient?"

"It's my lover." The middle-aged man replied cautiously.

"How many years ago was the splenectomy performed?" Zheng Ren asked.

"Twenty-two years ago, there was a car accident and a splenectomy was performed." The man replied immediately.

Generally, when a doctor sees a film, the first question they ask is about splenectomy, not a mirror image, nothing special.

Zheng Ren continued to watch with his chin resting on his shoulders. The professor stood behind him, also concentrating on reading the film.

It's been a long time since I watched a movie with my boss. This feeling is really great.

A few minutes later, the professor said: "Boss, this liver cancer is a bit strange, why don't I think so?"

"Well, it's a little strange, but it's hard to say if it's not liver cancer." Zheng Ren held his chin, looked at the film, and said, "I highly suspect it's ectopic spleen implantation, not liver cancer."

"What?" Professor Rudolf Wagner was surprised, "Boss, how did you find out? Is this a bit bald and twisted?"

As he said that, the professor clicked on a location with an abnormal signal on the film.

"It's not all there, it's just a little signal abnormality. Fugui, have you noticed that the patient has undergone interventional embolism once."

"I noticed." Professor Rudolf Wagner heard Zheng Ren talking about embolism, and seemed to remember something, staring at certain frames of the film carefully.

Zheng Ren didn't continue to explain. Regarding the professor's level of film reading, what he said is enough.

The middle-aged man was puzzled.

Ordinarily, shouldn't liars say that the more serious the illness, the better? But how could this young "doctor" say it wasn't liver cancer?

Ectopic what planting?

Is it transferred?

With his mind full of doubts, his ears pricked up, wanting to listen to the conversation between Zheng Ren and Professor Rudolf Wagner.

But the two of them fell silent afterwards, without saying a word, and began to "face each other" in front of the film.

A few minutes later, the professor made a fist with his right hand and hit the palm of his left hand with a "snap". This movement is perfectly learned by the professor and Su Yun.

"Boss, I figured it out! It is indeed an ectopic spleen!" Professor Rudolf Wagner said happily.

"Well, the diagnosis is relatively clear. Especially after an interventional embolization treatment, it has been basically confirmed." Zheng Ren said.

After finishing speaking, he took off the film, put it in the film bag, and said: "Go to Teacher Yang, and I will write it on paper after the diagnosis. For this disease, Teacher Yang will perform a resection operation, and the postoperative pathology A diagnosis is enough."

As he spoke, Zheng Ren found a piece of discarded A4 paper. He scratched the writing on the front a few times to indicate that it was invalid, and then wrote his diagnosis and surgical advice on the back.

The patient's family was stunned.

He had already sketched out many possible words Zheng Ren might say in his mind, and he made contingency plans for each one.

He knew what to do if he was a liar.

However, the young "liar" actually sent himself back to the general surgery department.

Could it be that I guessed wrong?

The middle-aged man held the paper in his hand, looked at the words on it carefully, and became puzzled.

"Go ahead. I heard from Teacher Yang that your lover had epigastric pain all year round. It was caused by the spleen planting and the backlog of the liver. It's nothing serious, just remove it." Zheng Ren said, taking out his phone.

He first left a note on Professor Yang's cell phone, and then dialed it.

"Mr. Yang, I have finished watching the patient's film."

"Well……"

"Okay, okay. Brother Yang, the film is considered to be ectopic spleen implantation, not liver cancer."

"Yes, yes, your judgment is correct. If there is a bed, you should be admitted to the hospital and undergo a resection operation. Pathology... During the operation, it can be seen that it is spleen tissue."

"Oh, okay, the patient's family is here. I'll take it up..."

"Okay, then I'll wait for you."

After finishing speaking, Zheng Ren hung up the phone.

"Teacher Yang...Brother Yang told me to come down later, so I won't meet you later." Zheng Ren and the patient's family said.

The patient's family members were stunned, and the development of the matter had completely deviated from his expectations.

Soon, Professor Yang hurried to the interventional department wearing an isolation suit and a sterile cap.

"Boss Zheng, I don't think it's liver cancer." After entering the door, Professor Yang said hastily.

It seemed that he had just left the stage not long ago, so he didn't even have time to change his clothes. It is even possible that during the intermission period of the operation, I took the time to run down.

"90% probability is ectopic spleen planting." Zheng Ren nodded.

Zheng Ren can't and dare not guarantee 100% of such things. If freezing during surgery is malignant, there is no way to explain it.

Without a pathological gold standard, Zheng Ren would have doubts about the diagnosis of big pig's trotters.

"Boss Zheng, your level is really high." Professor Yang praised: "Tell me, how did you find out."

Zheng Ren felt a little strange, an autologous liver transplant, Professor Yang is like this?

But when he saw that Professor Yang was concentrating on watching the film, he seemed to be speaking from his heart, so he smiled without thinking too much about it.

"You are not involved in intervention, so you don't know much about the images of intervention." Zheng Rendao: "The patient underwent an interventional embolization. Look here. From the image of lipiodol deposition after embolization, there are only embolism necrosis, and typical The liver cancer foci did not appear on the image."

"There are very few liver cancers that show this kind of image. Coupled with the patient's medical history, intermittent abdominal pain for many years, and a history of splenectomy 22 years ago, I judge that the possibility of ectopic spleen implantation is relatively high."

Professor Yang watched the film, and Zheng Ren's words solved several of his doubts, but the reasons were not very sufficient.

Zheng Ren's words can deny liver cancer with a high probability, but spleen implantation cannot be denied.

"Boss Zheng, if the spleen is planted..."

"The preoperative 64-slice CT enhancement showed that the lesion was uniformly enhanced in the arterial phase and slightly enhanced in the venous phase. Angiography showed that the branch of the hepatic artery supplied the round mass with rich blood supply. At this time, it was suspected to be liver cancer. There is no mistake." Zheng Ren said, picking out another film from the film bag.

"Reexamination after surgery shows that the MRI arterial phase enhancement is not obvious, but the metastatic lesions on the abdominal wall have the opposite characteristics." Zheng Rendao: "Because the blood vessels of the abdominal wall lesions are relatively thin, there is no embolization treatment, which is consistent with the intervention of splenomegaly. The images after embolization are very similar."

Interventional embolization therapy for splenomegaly and cirrhosis can effectively increase the values ​​of white blood cells and platelets.

Although Zheng Ren has never done it before, interventional surgery is close to the peak, and he is familiar with this kind of "minor surgery".

"So, I'm quite sure that the local doctor performed a splenic embolization operation." Zheng Ren smiled.