Chapter 1868: with translation of chapter title

1802 Splenic pregnancy? No! (Monthly ticket 18500 extra chapter ×37)

Ectopic pregnancy, ruptured hemorrhage, peritoneal signs—these are all obvious.

Zheng Ren needs to find the exact location of the ectopic pregnancy.

If we can locate it, the patient won't suffer greater injury during surgery and will recover a bit faster post‑op; in other words, we won't make a large incision and rummage around.

If we do that, postoperative intestinal obstruction or similar issues will likely arise.

The ultrasound machine was brought over, and Zheng Ren began scanning the patient.

He does it meticulously, starting from the lower abdomen and pelvic cavity, moving upward bit by bit.

The patient's family members stand anxiously to one side; it's obvious they still don't quite understand a young doctor performing the exam.

Soon, the inpatient chiefs of the hepatobiliary and obstetrics departments came running down.

Zhou Litao first called Zheng Ren, then contacted the relevant departments—an implicit trust that when faced with difficult cases, they seek Zheng Lao Ban.

In his mind, the three words 'Zheng Lao Ban' are no different from the little ads on telephone poles advertising old Chinese doctors or old military doctors.

Telling Su Yun that seeking rheumatology and immunology for difficult cases is the same principle.

'Manager Zhou, what's the situation?' the obstetrics inpatient chief exclaimed, seeing Director Lin standing in the emergency resuscitation room, and lowered his voice a bit.

Zhou Litao gave a briefing of the condition and stated his judgment.

Actually, the condition judgment is still simple; the key is the location, which is the difficulty. The ultrasound room doctors didn't find it, so now we can only rely on Zheng Lao Ban.

The obstetrics and hepatobiliary inpatient chiefs stood with hands at their sides; with Lin Ge present, even their breathing became much gentler.

'No abnormalities were found in the intestinal tract; a small amount of fluid‑dark area is visible in the intestinal spaces, suggesting bleeding.' Zheng Ren briefly described it, and Zhou Litao recorded his words.

After all, an examination requires a report. The ultrasound doctor is busy, so only Zhou Litao can record it to pass on to the doctor over there.

Continue scanning upward.

When scanning reached the spleen, Zheng Ren discovered the problem. An abnormal echo appeared on the screen, and the two inpatient chiefs realized the problem had likely been found.

'In the lower pole of the spleen, there is a 2.6 cm × 1.6 cm × 2.0 cm heterogeneous, slightly hyperechoic mass with clear borders, relatively regular shape, containing a 0.9 cm anechoic area, and multiple point‑like blood flow signals around and within the mass.' Zheng Ren said.

Zhou Litao quickly recorded that passage.

The hepatobiliary inpatient chief felt this was a rare case of splenic pregnancy, and in any case it falls under hepatobiliary surgery.

But as soon as he moved, he saw Zheng Lao Ban sitting there, motionless like a mountain.

Haven't we found the problem's location?

The hepatobiliary inpatient chief was stunned; why isn't Zheng Lao Ban relieved, but still observing?

Lin Ge doesn't understand ultrasound, but he understands people and reads them well.

He sees the subtle movements of several people clearly.

'Any judgment?' Lin Ge asked.

'Consider it a splenic pregnancy.' The hepatobiliary surgery inpatient chief said: 'It's rare, but the surgery isn't difficult; I've done it before.'

'Huh?' Lin Ge saw Zheng Ren holding the ultrasound probe pressed against the patient's left upper abdomen, staring at something, knowing something was wrong, and asked, 'What is Zheng Lao Ban doing?'

'……' The hepatobiliary surgery inpatient chief didn't know how to answer.

'Perhaps he's looking for the fetal heartbeat and fetal bud?' the obstetrics inpatient chief said.

Lin Ge nodded, noncommittal.

Time trickled by; Zheng Ren stared at the ultrasound screen without speaking.

The patient's family members were so anxious they just jumped up and down, pacing back and forth, suppressing their agitation and inner fire.

'Doctor, what are you looking at?' the patient, drenched in sweat from pain, whispered.

'I'm looking for the fetal heartbeat; don't speak, take a deep breath, hold it until you can't.' Zheng Ren said.

'Are you capable or not!' a middle‑aged woman finally couldn't hold back her anger, lowering her voice: 'Pressing you like that, you don't feel pain!'

'Sorry, there's nothing I can do; please bear with it a little longer.' Zheng Ren said calmly: 'Since it involves the surgical area, if the examination isn't thorough, it could easily lead to a second laparotomy.'

'You're just trying to scare people.' The middle‑aged woman's expression shifted; she muttered something under her breath but didn't continue.

One minute later, Zheng Ren moved the ultrasound probe away from the patient's spleen area and began to examine the liver region.

The emergency ultrasound doctor finished her current task, hurried over to the emergency resuscitation room, saw Zheng Ren scanning, and let out a sigh of relief.

Zheng Lao Ban is still steady—everyone acknowledges that.

'Manager Zhou, what's the situation?' she asked cautiously, sidestepping Lin Ge and approaching Zhou Litao.

'In the lower pole of the spleen, there is a 2.6 cm × 1.6 cm × 2.0 cm heterogeneous, slightly hyperechoic mass.' Zhou Litao said.

'Uh...' the previous situation, the ultrasound room doctors all knew.

'Have we encountered a rare splenic pregnancy?' she hurried to look at the ultrasound screen.

Zheng Lao Ban is scanning the liver—if splenic pregnancy is already confirmed, why is he still looking at the liver?

She was somewhat confused.

'Zheng Lao Ban,...' the ultrasound doctor asked softly.

'The echo in the spleen's lower pole—I looked for a few minutes and didn't see a fetal heartbeat or bud; I consider it a hemangioma.' Zheng Ren said, 'There is fluid in the liver area, and the hepatorenal recess fluid depth is 3.3 cm.'

Zhou Litao immediately recorded Zheng Ren's description of the ultrasound findings.

'Do you see any problem in the liver?' the ultrasound doctor asked.

'No, the visible parts of the liver surface show no problems.' Zheng Ren said.

'That must be a splenic pregnancy; the rupture caused bleeding that flowed here.' the ultrasound doctor whispered.

Although the voice was soft, to the patient's family it took on another meaning.

They don't know what splenic pregnancy is, but ruptured hemorrhage is a serious matter.

Add the patient's pallor and drenched sweat, and their agitation becomes harder to contain.

'Manager Zhou, consider it a hepatic ectopic pregnancy; order a CT, and prepare the hepatobiliary side for laparoscopy.' Zheng Ren finally put down the ultrasound probe and said firmly.

Eh...

This Conclusion is a bit strange.

Seeing the problematic spleen, there was no issue instead. How could he say the liver has a problem?

The key is that the liver still shows no abnormal image.

The B-ultrasound doctor was stunned for a moment; she dared not agree with Zheng Lao Ban's diagnosis.

"Doctor, is everything alright?" the patient's family asked anxiously.

"Bleeding, need emergency surgery." Zheng Ren said, "Can it be done?"

The Hepatobiliary Inpatient Chief nodded; he merely dared not agree with Zheng Lao Ban's diagnosis, but the surgery was fine.

This surgery is minor; an Inpatient Chief–level emergency doesn't even require bringing in an associate professor—just bring along a trainee doctor and go straight to the operating table.

The spleen surgery is fine, but the liver…… an Inpatient Chief–level isn't enough to handle it.

"Hmm." Zheng Ren nodded, "Hurry up and do a CT; call me when it's done so I can look at the images. Notify the Operating Room to prepare for surgery."