Chapter 315: What Xiao Ji and I Think

"Spinal stenosis is very common in our Orthopedics Department. Most patients do not require treatment because vertebral surgery is quite difficult, and no one wants to perform it without absolute certainty." Seeing that Ji Xiang was easy to communicate with and not stubborn, Deng Chaohong began his mode of earnest instruction.

His teaching style was different from the System NPC; it was not long-winded, which likely had to do with his age and Deng Chaohong's character.

Ji Xiang listened attentively, and Deng Chaohong took advantage of the time the patient was away to retrieve the films to tell Ji Xiang a bit more.

His basic skills were solid, and he performed surgeries well; otherwise, Dean Zhao Jixiang would not have sent his son to Deng Chaohong.

Ji Xiang listened with great interest.

About ten minutes later, the patient returned, limping while carrying the films.

"Professor, I'm back. Here are the films, please take a look." The patient handed the film bag to Deng Chaohong.

"In a moment, when you look at the films, you will know what spinal stenosis is." Deng Chaohong smiled, pulling off the demeanor of a teacher to the fullest, and then some.

"Click—"

The films were inserted into the film viewer.

Deng Chaohong glanced at them, and he froze.

He had actually "guessed" wrong; the patient's problem was not the spinal canal!

Inside the spinal canal, anterior to the dura mater, there was a cord-like, tortuous abnormal space-occupying shadow. Both T1 and T2-weighted images showed low signals, distributed behind the L4-S1 vertebrae, most notably at the L4/5 interspace level. Two longitudinal arches of the anterior internal vertebral venous plexus were dilated, located ventral to the dura mater, forming the specific imaging appearance of the "glasses sign."

The very typical "glasses" sign appeared. Professor Deng stared blankly at the "glasses" on the film, and after a few seconds of stunned silence, he tried hard to recall what he had actually seen during his physical examination.

The physical examination process was not difficult: joint pain, no other neurological symptoms in the limbs, which quite matched the clinical signs of spinal stenosis.

But!

Deng Chaohong thought of the question Ji Xiang had just been "lectured" on by him in a soft-spoken manner.

"It's not spinal stenosis; there is a problem with the blood vessels." Although Deng Chaohong did not want to admit it, there was no point in stubbornly holding on to the end.

Deng Chaohong did not even think about how to choose between his own face and a correct diagnosis and corresponding treatment.

Wasn't it obvious how to choose?

"The doctors in our local area didn't understand it," the patient said, full of hope. "They told me to come to the Provincial Hospital to take a look."

"Sit up."

The words Ji Xiang had said to the patient over ten minutes ago echoed in Deng Chaohong's ears.

He felt his old face flush a little.

But with a misdiagnosis, what else could he do?

It must be a rare disease; following Ji Xiang's line of thought to continue the physical examination was also a good choice, Deng Chaohong consoled himself.

The patient took off his socks.

Just as he was taking off his socks, Deng Chaohong's eyes widened in inexplicable astonishment.

The patient was wearing a pair of black socks, but there was almost no difference between having them on and having them off.

Taking off the socks even gave Deng Chaohong the illusion that the patient had been wearing another pair of socks inside the socks!

No!

As a doctor, Deng Chaohong immediately sensed that something was wrong.

But he couldn't quite say what was wrong. As for the underwear or socks fading, that was even rarer than a rare disease; few patients he usually saw would be scatterbrained to that extent.

"I wash my feet every day, I don't know why the socks are fading, really," the patient said nonchalantly. "Professor, do you need me to lie flat?"

"Mm." Deng Chaohong nodded absent-mindedly.

Seeing that Ji Xiang didn't speak, he began the physical examination.

A few minutes later, Deng Chaohong went to wash his hands. "Is your blood sugar normal?"

"It's normal, I don't have diabetes."

According to the description in the books, the patient's condition was called pigmentation in the gaiter area, which was extremely rare; Deng Chaohong himself had only seen it once or twice.

What was the diagnosis again? Deng Chaohong struggled to find the remaining fragments of memory in his brain.

"Doesn't your stomach hurt?" Ji Xiang suddenly asked.

Stomach, abdomen...

Ji Xiang's question was like a bolt of lightning; Deng Chaohong immediately thought of a patient he had encountered years ago when he went for a consultation.

In the end, the patient should have been admitted to the Vascular Department.

"It doesn't hurt." The patient grinned.

Although Ji Xiang was a young doctor, he still gave him enough politeness and respect.

"Xiao Ji, what do you think it is?" Deng Chaohong, like the patient, also gave Ji Xiang full respect.

He never thought of Ji Xiang as just a Standardized Training Student; which Standardized Training Doctor could break so many records in Tying Knots? So this time, Deng Chaohong followed the advice readily, "knelt" immediately, and prepared to listen to what Ji Xiang had to say.

"I have a feeling it's like Budd-Chiari Syndrome." Ji Xiang stated the diagnosis given by the NPC when he had gone to the System Operating Room to seek advice earlier.

"Uh..." Deng Chaohong was startled, then said, "You, lie down, expose your stomach."

The patient was a bit surprised, but still lay down according to Deng Chaohong's words.

Lifting the clothes, several thick veins on the patient's stomach were winding like worms, and they seemed to be moving along with the blood flow.

Venous engorgement, pigmentation in the gaiter area—these keywords and the Magnetic Resonance Imaging all unanimously signaled to Deng Chaohong that the patient was definitely not a simple case of spinal stenosis!

"I'm going to make a phone call." Deng Chaohong patted the patient, signaling him to get up.

"Professor, what phone call are you making?" the patient asked.

"I'm finding others for a consultation. Looking at your current situation, it doesn't seem to be a disease for our Orthopedics Department," Deng Chaohong said, trying to suppress his inner emotions and gently explaining to the patient. "Don't worry, coming to the Second Affiliated Hospital, there is a high probability of getting a clear diagnosis."

The patient was very relieved.

After traveling hundreds of miles and spending dozens of days, wasn't it all for the sake of a correct diagnosis?

Deng Chaohong turned and left, looking back at Ji Xiang just before stepping out the door.

A few minutes later, Deng Chaohong returned with Director Wang from the Vascular Department and Director Zhao Xiangming from the Interventional Department.

"I... and Doctor Xiao Ji suspect it is Budd-Chiari Syndrome," said Deng Chaohong.

"The stomach doesn't hurt? Why insist on coming to your Orthopedics Department? Does the Patient have the physical signs of a spider-man?" asked Zhao Xiangming.

After entering the door and taking a look at the Patient, Zhao Xiangming smiled, "It probably isn't. More than ten years ago, I was watching the NBA draft, and there was a tall guy, a spider-man with long arms and legs; I felt that if his stomach were a bit bloated, he would definitely be a Budd-Chiari Syndrome patient."

KD? Ji Xiang smiled; what Zhao Zhuren said was actually quite similar.

Although he said that, Zhao Xiangming immediately went to perform a physical examination.

Apart from the lack of abdominal pain and chronic ulcer symptoms, the Patient's symptoms—such as large, tortuous, distended veins on the chest and abdominal wall, pigmentation in the gaiter area, and a small amount of fluid detected by percussion in the abdominal cavity—all matched.

"I'm taking the Patient away; Budd-Chiari Syndrome isn't common, but the surgery is very simple," Zhao Xiangming comforted the Patient.

"Then..."

"Go with Zhao Zhuren." Deng Chaohong personally saw the Patient and Zhao Xiangming off.

This illness belongs to the Interventional Department to treat; having found the appropriate department for the Patient to receive treatment, Deng Chaohong was also very relieved.

(End of this chapter)