Chapter 1267: with translation of chapter title

The patient now has black stool, the report is out, occult blood in stool positive. After Zhu Liangchen finished reporting the medical history, he added a sentence.

This is the result just reported by his subordinate Deputy Chief; there's nothing to hesitate about, the diagnosis is clear, the patient has lower gastrointestinal bleeding.

Postoperative occult blood in stool positive, there are countless considerations. But after interventional procedure, it's not a hepatic interventional surgery; the patient himself has splenomegaly, liver cirrhosis, and gastric varices, yet occult blood in stool positive appears, which is too rare.

If we can't find the problem, Zhu Liangchen feels he won't be able to sleep.

Zheng Ren wasn't as polite as when he entered the room; while listening to Zhu Liangchen talk about the treatment process, he stared at the film.

Habitually, Zheng Ren rested his right hand on his cheek, left hand under his right armpit, eyes narrowed.

After Zhu Liangchen finished reporting the medical history, he also looked at that film.

This isn't the latest film; will Zheng Lao Ban directly say no and ask to retake it? But what examination would reveal it? A colonoscope?

Zhu Liangchen had considered countless possibilities; fortunately, at home they reported to him that the patient's condition was stable and the bloody stool hadn't worsened, which gave him slight relief.

A full ten minutes passed before Zheng Ren said: "The CT isn't very clear."

Zhu Liangchen felt chilled halfway; this is like Tai Chi, a delaying word that experienced doctors all use.

Is Zheng Lao Ban truly unaware, or just brushing me off?

But just as that thought arose in his mind, Zheng Ren continued speaking.

"But the ulcer surface at the pylorus has already shown up."

"……" Zhu Liangchen and Director Kong both furrowed their brows.

CT cannot see hollow organs, such as the gastrointestinal tract. If there were a large solid tumor, CT could see it, but the patient isn't a tumor.

"Director Zhu, I don't know if you've noticed, but the patient's gastric wall shows dilation." Zheng Ren continued.

"I've noticed; I'm considering that embolization of part of the artery leads to insufficient blood supply, causing delayed gastric emptying." Zhu Liangchen immediately said.

Zheng Ren shook his head and said: "The problem indeed lies in delayed gastric emptying; postoperative medication, let me see the medical orders."

He was speaking in fragments, but Zhu Liangchen didn't argue; instead, he took out his phone and pulled up the photographed medical orders.

When asking for help, one must have the proper attitude; moreover, just now Doctor Mehari came to view the film, the sight of a row of foreign experts leaning against the wall completely shocked Zhu Liangchen.

He had no other thoughts, kneeling thoroughly.

After Zheng Ren finished looking, he had a complete treatment plan in mind. He paused and said: "Director Zhu, go back and do a gastroscopy, remember to take a biopsy."

"A biopsy?" Zhu Liangchen exclaimed, "Did I just encounter a rare malignant tumor? Impossible; I've looked at those films so many times, how could I have missed it?"

Zheng Ren merely spoke to himself, his pace slightly slow, never expecting Zhu Liangchen to have thought of so many things in that moment.

"Biopsy tissue, do bacterial culture." Zheng Ren said.

"Bacterial culture? What do you suspect?" Zhu Liangchen wanted to ask, "Helicobacter pylori? That's nonsense."

"Are you familiar with the lab?" Zheng Ren suddenly asked.

Even Su Yun felt that his own boss was appearing and disappearing mysteriously; could it be that after communicating with Doctor Mehari, he had swollen to outer space?

"Not bad."

"When sending the specimen, Director Zhu, you personally greet your acquaintances in the lab; it's not an ordinary bacterial culture, we need to check for Streptococcus octavus." Zheng Ren said.

"……" Zhu Liangchen was speechless.

"……" Director Kong was also speechless.

Only Su Yun raised his eyebrows slightly, as if he had thought of something.

"Zheng Lao Ban, what is that?" Zhu Liangchen sincerely didn't know whether Zheng Lao Ban was making things difficult for him or really something else. He had come today to admit fault and apologize; Zheng Lao Ban's welcoming smile already counted as special favor. So he could only whisper his question, daring not to say more.

"Streptococcus octavus commonly aggregates eight bacterial bodies in a regular stack, forming a cube; it is a microaerophilic bacterium, easily isolated from soil, and can also be found in gastric contents of gastric disease patients."

Zheng Ren pointed to a spot of uneven density on the film and said: "Here, I consider it a pyloric ulcer; the ulcer surface area is not small."

"Streptococcus octavus growing in the human stomach causes certain pathological changes, such as pyloric ulcer and pyloric stenosis, leading to delayed food passage into the intestine. Under these abnormal conditions, the stomach is in an acidic environment; carbohydrates and other growth nutrients in the food promote rapid proliferation of Streptococcus octavus."

Zhu Liangchen listened, dazed, and asked vaguely: "Then what?"

Zheng Ren was also somewhat surprised, turning his head to look at Zhu Liangchen, as if seeing something incomprehensible.

"Boss, the interventional doctors all come from imaging." Su Yun whispered from the side.

"Oh oh." Zheng Ren then realized.

Director Kong's and Zhu Liangchen's faces felt as if they'd been slapped several times; they really wanted to press Su Yun to the ground and beat him up.

Are those from imaging not doctors?

"Professor Goodsir first discovered Streptococcus octavus in patients' stomachs in 1842. In 1872, Professor Ferrier also found it in patients' blood and believed its presence in the blood was related to delayed gastric emptying." Zheng Ren then explained.

"It's normal that Director Zhu doesn't know; clinically, the department most commonly encountering Streptococcus octavus is General Surgery Department, even the Gastroenterology Department isn't that common."

"General Surgery Department? Why?" Director Kong asked.

"Because of the prior gastric banding surgery, under normal circumstances the likelihood of postoperative Streptococcus octavus appearance is quite high." Zheng Ren chuckled, "So I said that paper from Johns Hopkins Hospital is worth discussing; the reason lies here."

"That paper didn't mention how to prevent or treat Streptococcus octavus post-surgery, nor any complications; it only said long-term efficacy was relatively good."

"I still wanted to wait until Doctor Mehari left to ponder it properly, but Director Zhu went ahead first." Zheng Ren said solemnly; anyway, from his tone one couldn't hear mockery, and Zhu Liangchen felt a turmoil inside.

He really couldn't explode, yet not exploding left him feeling stifled. Especially seeing Zheng Ren's honest face made him even more helpless. Zheng Ren wasn't deliberately mocking him, Zhu Liangchen knew that.

But the more this happened, the more it showed that his previous actions were extremely foolish.

Director Kong gave a wry smile; it turned out to be a common complication after gastric banding surgery in General Surgery Department, no wonder that guy Su Yun reminded Zheng Lao Ban that interventionalists are all from imaging.

Who the hell would know about that damned Streptococcus octavus if they'd never done gastric banding surgery?

Thinking about it, Director Kong's heart already couldn't help wanting to curse.

This is practically an insult to interventional doctors; but… they're right, what can I do?

Director Kong sighed.