Chapter 1831: 1767 Missing Small Detail (Monthly Ticket 3500 Bonus Chapter ×7)

The demonstration room was perfect, yet the case seminar that followed was a failure.

The stone that should have been in the patient's ureter simply does not exist, although all symptoms point to it being somewhere.

Yu Zong also felt a bit down; in his mind, Boss Zheng was already synonymous with omnipotence.

But Boss Zheng hardly spoke, just sat there in thought, until finally Su Yun had no choice but to end the case seminar.

Yu Zong and Chang Yue returned to Headquarters; Su Yun turned off the machine, sighed, and said, "Boss, what are you thinking about?"

"I'm thinking about all possible diseases that could cause the patient's renal colic." Zheng Ren sat in his seat, and a strand of sunlight happened to fall on his face.

"Useless." Su Yun said, "I suggest Yu Zong contact the Rheumatology and Immunology Department for a consultation."

"You really go to rheumatology and immunology whenever you don't understand something?" Zheng Ren spoke softly; his mind split into two parts—10% for casual chatter, the other 90% quickly searching his memory for cases he'd encountered or seen.

"What should we do then?" Su Yun said, "Systemic lupus erythematosus could present these symptoms, but we can't diagnose it."

"Have the tests been done?"

"Yu Zong will do it when he gets back." Su Yun said, "Doing the tests to rule out immune system diseases is really a big project."

"Let me think again." Zheng Ren said, "Do you see anything different about him?"

"Huh?" Su Yun glanced at Zheng Ren and asked, "Boss, with inspection, auscultation, inquiry, and palpation—are you using me as your eyes?"

Zheng Ren smiled and said nothing.

He had no idea at all; if worse came to worst, he'd go look at the eye patient later and refer to the Big Pig Trotter's system diagnosis.

He felt no sense of failure, and Zheng Ren didn't think one had to stay away from the Big Pig Trotter to achieve anything; facts are facts, they can't be changed.

Besides, if there's a good way to relieve the patient's pain, why obsess over whether the diagnosis is his own or the Big Pig Trotter's?

He had studied hard, yet couldn't make a correct diagnosis, which only showed he was still a bit weak; but since the comparison was against the system, Zheng Ren didn't feel embarrassed.

After figuring it out, Zheng Ren stretched, smiled, and said, "The new VR equipment is indeed not bad."

"Various configurations will keep arriving from all over the world; Chu Nu Ang Sai's word is binding." Su Yun said, "I hope he stays healthy and lives long."

"What do you think the patient has?" Zheng Ren didn't take the bait, mentioning Chu Nu Ang Sai, but instead steered the conversation back to the patient before him.

"I don't know. When I examined him, he was in great pain, sweating all over. It's said renal colic attacks every three minutes, growing more frequent, almost forcing a position." Su Yun said.

"Does he have a board-like abdomen?"

"His six-pack abs are well maintained, feeling rock hard to the touch." Su Yun said, "It's rare for someone in their forties to have no belly."

"Did you remind Yu Zong to check for peritonitis?" Although Zheng Ren had examined the abdominal CT and confirmed the patient had no peritonitis, he still blurted it out.

He spoke while thinking, the patient's symptoms were a bit strange, yet he felt he had grasped some clue.

"I asked, and they said it's been like this since hospitalization. At first they highly suspected peritonitis, but after CT, ultrasound and other auxiliary tests they concluded the person's body was fine." Su Yun said.

Zheng Ren had seen people like this—healthy, with muscles all over, hard as rock.

He could picture Su Yun's examination: the patient curled up like a shrimp on the bed, drenched in sweat, muscles merely tensed, forced into position.

Renal colic, when it hurts, is truly deadly.

In the Northeast, it usually occurs in the early morning of spring and autumn, around three or four a. m.; sometimes the Emergency Department sees three to five patients within a few hours, all clutching their stomachs.

In the recent medical orders, Zheng Ren saw the use of antispasmodic drugs.

But the effect wasn't obvious, after all there was no stone at all, and it wasn't simply a ureteral smooth muscle spasm.

Uh… just a ureteral smooth muscle spasm?

"Does the patient have nausea or vomiting?" Zheng Ren felt he might have found a key point.

"No." Su Yun shook her head and said, "Don't waste your energy, Boss. When smooth muscle spasm causes colic, the attack is accompanied by pallor, cold sweats, nausea, vomiting; severe cases show weak rapid pulse and dropping blood pressure." Su Yun said, "I deliberately waited a few minutes; during a major renal colic episode, the patient only had pallor and cold sweats—nothing else."

"Strange." Zheng Ren felt Su Yun hadn't said everything, and her account didn't match the idea that had just flashed through his mind.

"What exactly is it?"

Zheng Ren disliked this feeling.

It was right before his eyes, yet he just couldn't recall it.

It must be some detail; he looked out the window and began recalling every word and every detail of this consultation from the start, searching for the point he'd forgotten.

"Let's go look at the patient." Zheng Ren thought for two minutes, still couldn't grasp that thread of thought, so he could only sigh and say.

It was right before his eyes, yet he just couldn't grasp it.

"I thought you'd figure it out." Su Yun looked at Zheng Ren with disdain and said, "I thought you'd mention checking the sedimentation rate or say the patient had primary kidney cancer, with the tumor tissue happening to grow near the nervous system, thus…"

"No, immune system diseases causing pain rarely present colic symptoms. Primary kidney cancer, though rare, can invade nerves; I'd considered that and even done a 64-slice 3D reconstruction." Zheng Ren said, "It's not any of those possibilities you mentioned."

"How about parathyroid dysfunction? That can also cause hematuria." Su Yun asked.

"What we need to consider are both hematuria and renal colic, not just one." Zheng Ren said, "Besides kidney stones, I really can't think of anything else…"

Saying that, he froze.

Su Yun saw Zheng Ren staring blankly at her, blew out a breath, and said, "Do I have flowers on my face?"

Zheng Ren didn't speak, merely furrowed his brows slightly.

"Are you stupid?" Su Yun said, "It's just a rheumatology and immunology consultation; you don't need to be so stubborn."

"No, don't speak yet." Zheng Ren said, "I think I've come up with something."

Su Yun looked at Zheng Ren curiously, wondering if this guy could link renal colic and hematuria while ruling out stones as the cause.

Not likely.

Soon Zheng Ren asked, "You just said he plays badminton? Is he a national-level athlete?"

"Huh, how so?" Su Yun laughed, "Want to exercise? Or are you saying you want to go night‑running with Xiao Yi Ren in the evening?"

"No, I think I know what the patient has." Zheng Ren said, "Go check the patient, and have Yu Zong do an MRI."

"What MRI?" Su Yun asked curiously.