Chapter 421: How Much Do You Know About Mirizzi Syndrome?

"Do you have any questions?" Zhai Yuhan waited until Ji Xiang had left the patient's room, then she turned back to close the door and asked, puzzled.

"The patient has right upper quadrant pain without radiation; it is intermittent, progressive, and severe, rated 6/10. There are no obvious aggravating or relieving factors for the pain, the relationship with food intake is unclear, and it is associated with nausea, jaundice, darkened urine, lighter stool color, and a subjective feeling of fever."

"I didn't see these things written in the medical record. Teacher Zhai, you and the director must know about them, right?"

"..." Zhai Yuhan froze for a moment, then felt annoyed in her heart.

Was Ji Xiang provoking her?

Just a moment ago, she had used the tone of a superior doctor to ask him and Zhao Mengmeng some simple clinical basic knowledge and interview techniques, but Ji Xiang had turned around and started to counterattack.

He really was an arrogant and aggressive young man.

"I think we still need to do a Magnetic Resonance Imaging to confirm. By the way, does our department have an ERCP shi?" Ji Xiang asked, looking very "casual."

He hadn't rotated to the Hepatobiliary and Pancreatic Surgery department yet at the Second Affiliated Hospital of Baiyi University, but in his memory, during one of his Empathy sessions, he remembered that the Gastrointestinal Surgery department of a large hospital had a gastroscope, so he asked.

Zhai Yuhan's expression grew even uglier.

ERCP is always performed by Digestive Medicine Department doctors; there are not many Hepatobiliary and Pancreatic Surgery doctors in the country who can perform ERCP. Only a few hospitals in the Imperial Capital and Shanghai have an ERCP shi in their Hepatobiliary Surgery Department.

Was this a slap in the face?

Seeing that Zhai Yuhan didn't speak, Ji Xiang hesitated and gave a wry smile, "Sorry, Teacher Zhai. If there isn't one, that's fine too. I suggest doing an emergency Magnetic Resonance Imaging, and then finding an ERCP teacher tomorrow for a consultation."

"Doctor Xiao Ji." Zhai Yuhan suppressed the anger in her heart, trying her best to appear calm in front of the camera to avoid being criticized.

"Teacher Zhai, it's like this." Ji Xiang's eyes were very bright, and his face radiated a gentle luster, as if a lighting technician had cast a beam of light onto his face.

Zhai Yuhan was stunned, losing her focus for an instant.

This was just too good-looking!

She wasn't a superficial person, but in this instant, it was as if flowers were falling from the sky and celestial music was playing around Ji Xiang.

But Zhai Yuhan quickly woke up, feeling slightly angry and embarrassed.

"What do you think?" Zhai Yuhan asked unhappily.

She didn't want to pay any attention to Ji Xiang at all, but there was a camera there after all.

"Teacher Zhai, the patient has a rare Mirizzi syndrome. That should be it, but we still need a Magnetic Resonance Imaging to confirm the diagnosis."

"Mirizzi syndrome? Student Xiao Ji, the patient's gallbladder has already been removed!" Zhai Yuhan said sternly.

"It's not Mirizzi syndrome caused by a stone compressing the gallbladder neck, but rather..."

As Ji Xiang spoke, he strode toward the Doctor's Office.

The camera crew behind him was completely dumbfounded. What kind of plot was this? Was it arranged by the director?

Was the patient also a temporary actor?

Ji Xiang's confident tone made them think that everything was arranged.

They had been tricked; everything was a script, and the director was just controlling everything from behind the scenes.

The cameraman had been a bit sleepy, but he woke up instantly upon seeing this scene.

In the Review Room, the host's bald head was shiny and bright as he looked blankly at Professor Shen.

"Mirizzi syndrome..." Professor Shen lowered his head to flip through his phone, looking up the technical term Mirizzi syndrome.

He was not a Hepatobiliary and Pancreatic Surgery doctor, so he also needed to search online when encountering such an extremely professional term as Mirizzi syndrome.

Soon, Professor Shen raised his head, his scholarly face showing some confusion.

In his view, Ji Xiang was just a Standardized Training Student, and Zhai Yuhan was the Resident Chief of the Affiliated Hospital. Moreover, this patient was clearly an old patient of the Affiliated Hospital whom the director had seen countless times; how could Ji Xiang be the one to provide a new diagnosis?

It was impossible.

This wasn't scientific!

But all these doubts wavered under Ji Xiang's determined gaze.

The Review Room was silent, and the atmosphere was a bit awkward, but Fan Dao was extremely excited, his eyes shining brightly.

This was the point he wanted!

Ordinary people are interested in the work and lives of doctors; this was one of the selling points of the program.

And everyone knew that young doctors are subjected to all kinds of torment when they enter clinical practice, which is within reason.

But to create a hit, you need things to be within reason, yet beyond expectations.

Now, Ji Xiang was presenting all of this before Fan Dao.

Recalling that Ji Xiang had brought his own "work group," which included an "old" director who graduated from Peking Union Medical College Hospital, his expectations for Ji Xiang were pushed to the maximum.

"Group One, Group One, keep up! Keep the camera on Ji Xiang. Group Two, get a side shot of Doctor Zhai." Ignoring the host and guests in the Review Room, Fan Dao had already started directing his cameramen.

The cameraman followed Ji Xiang's footsteps at a light jog.

He grumbled to himself that Ji Xiang's legs were really long; he had to jog just to keep up with his long strides.

Returning to the Doctor's Office, Ji Xiang sat in front of the computer and pulled up the Ultrasound images.

"Teacher Zhai, look here."

"The ultrasound examination shows an enlarged cystic structure at the gallbladder bed, consistent with an increase in gallbladder remnants, and no ultrasound evidence of biliary stones was found."

Zhai Yuhan was stunned, "Doctor Xiao Ji, do you know what you are saying?"

"I do. Although the image on the Ultrasound is not definitive, there is an image here below that is approximate to an artifact."

Ji Xiang pointed at the screen with his finger.

"Don't you think there's something wrong with this image?"

"Something wrong? What's wrong?" Zhai Yuhan looked blankly at the image Ji Xiang was pointing to, having no idea what Ji Xiang was talking about.

"The imaging shows it is slightly thicker than a normal bile duct," Ji Xiang said. "If we perform a Magnetic Resonance Cholangiopancreatography to further evaluate the biliary tree, I estimate we can find a stone in the cystic duct remnant, accompanied by compression of the common bile duct and dilation of the upstream bile ducts."

"Look, it's this section. Although there is only a faint shadow, combined with the Patient's medical history, we can estimate the situation inside."

"!!!"

Zhai Yuhan was speechless.

Estimate?

Just by relying on a small section of the Ultrasound report image, he dared to say that?

"Teacher Zhai, our Shen Ke doesn't have an ERCP shi, but we can always schedule a Magnetic Resonance Imaging at night, right?"

Hearing Ji Xiang speak to her in this tone, Zhai Yuhan really wanted to grab him by the ear and tell him that Magnetic Resonance Imaging can indeed be done at night, but it requires the Director to make a phone call.

"Are you sure?" Zhai Yuhan asked.

"Pretty much. Teacher Zhai, how much do you know about Mirizzi syndrome?"

Zhai Yuhan cautiously glanced at Ji Xiang. She saw that Ji Xiang was focused on the computer screen and did not seem to be provoking her, but her competitive spirit was stirred, and she recalled her knowledge regarding Mirizzi syndrome in her mind once more.

"Mirizzi syndrome mostly refers to the impaction of a stone in the neck of the Gallbladder or the Cystic Duct and..."

Zhai Yuhan was explaining the technical term; she was indeed a Resident Chief at a high-level Grade A Tertiary Hospital, and her fundamental qualifications were excellent.

However, seeing this scene, the eyeballs of everyone in the Review Room nearly popped out.

If everyone had previously only felt that the roles of teacher and Intern had been swapped, then the question Ji Xiang raised directly erased the word "felt."

(End of this chapter)