Chapter 1869: with translation of chapter title

Zheng Lao Ban was too cautious; both Inpatient Chiefs and the B-ultrasound doctor made that judgment.

But the patient's condition—does it really allow another CT?

The Hepatobiliary Inpatient Chief glanced at the blood pressure—80/50 mmHg—seemed okay; there should be time for an abdominal CT.

The patient's family had already become impatient; to handle this well, we must immediately do the examination.

Hurry up and get onto the operating table; once we're in the Operating Room, it'll be fine.

Several people awkwardly lifted the patient onto the stretcher; Zhou Litao handed the examination slip to the patient's family; Zheng Ren leaned close to the Hepatobiliary Inpatient Chief and whispered: "Remove the spleen, you can do it. If the liver surgery isn't very certain, hurry up and call the second-line team."

The Hepatobiliary Surgery Inpatient Chief nodded blankly.

What he didn't understand was why Zheng Lao Ban insisted that a fine liver could have an ectopic pregnancy while a problematic spleen was fine.

But with Zheng Lao Ban's words, he breathed a sigh of relief.

In our department, from the Director to the Team-leading Professor, no one questioned his level when talking about Zheng Lao Ban in daily conversation. Although the Director rarely said so, the Inpatient Chief could see the Director's acknowledgment of Zheng Lao Ban's level.

The Director doesn't say it, but the reason is that Zheng Lao Ban forcibly tore a large opening in the liver cancer resection surgery using Interventional surgery.

Moreover, it's a live broadcast; doctors worldwide know that for liver cancer, doing Interventional surgery first improves surgical outcomes.

Specific long-term data need time to be gathered. But from the most basic surgery perspective, Interventional embolization plus surgical resection yields far better outcomes than pure surgical resection.

This is undoubtedly a huge blow to the Hepatobiliary Surgery department.

Um… overthinking. The Hepatobiliary Surgery Inpatient Chief thought, Zheng Lao Ban's meaning—calling the second-line team from home in the middle of the night—probably isn't a big deal.

Watching the group leave, Zhou Litao asked doubtfully: "Zheng Lao Ban, why isn't it about the liver?"

Generally, an ectopic pregnancy at 50 days should show a fetal heartbeat and fetal bud. The spleen's position, I think, resembles a hemangioma. In the spleen parenchyma, there is a round or oval heterogeneous hyperechoic mass with clear margins, uneven margins, and internal areas of anechoic and hyperechoic intervals.

But…

"Doing a CT won't affect the patient's surgery," Zheng Ren said. "If we give a hasty diagnosis, and bleeding continues after spleen removal, that's fucked up."

Thinking about that result, Zhou Litao felt a bit guilty.

Second time entering the palace, the first thing brought to the patient's family was an almost devastating psychological blow. Having come out fine, yet still bleeding—who could understand such a thing happening to anyone?

Definitely a hidden risk of medical dispute.

Although the patient's family is currently acting impatient, if the surgery goes smoothly, the patient will be fine afterward.

This is easy to empathize with. If anyone were the patient's family, they'd likely act the same.

"Is splenic pregnancy common?" Lin Ge asked.

"Not common." The B-ultrasound doctor immediately said.

Such a disease, even in a large tertiary hospital like 912, is rarely seen—usually not a single case per year.

"Among ectopic pregnancies, the incidence of abdominal pregnancy is only 1/10,000 to 1/30,000; splenic pregnancy is even rarer, with very few domestic and foreign reports." Zheng Ren said, "From 1990 to now, in journals and magazines with an SCI impact factor above 5, only about 40 cases have been reported."

Lin Ge smiled.

This logic of speaking with data is the standard mindset of a science-oriented male. Seeing Zheng Lao Ban say this often, I also feel a sense of agreement.

But this requires substantial reading and memory as a foundation to be able to recall it effortlessly.

If it were someone else, how could they casually spout such detailed data about a rare disease?

"Strange, how could it grow on the spleen or liver?" Lin Ge wondered curiously.

"According to research, the cause of splenic pregnancy may be that the fertilized egg, due to abnormal tubal reverse peristalsis, is expelled into the peritoneal cavity, not absorbed by the peritoneum, nor entering the opposite fallopian tube; meanwhile, strong intestinal peristalsis pushes the fertilized egg to the spleen or liver where it implants and grows." Zheng Ren explained: "The likelihood of hepatic ectopic pregnancy is slightly higher than that of splenic ectopic pregnancy."

Speaking, he lowered his head in thought, then continued: "Hepatic pregnancy: 22 cases; splenic pregnancy: 18 cases; less than 33% of patients have a gestational age over three months; most are diagnosed and treated in early pregnancy due to hemoperitoneum from miscarriage or rupture."

"Liver, for sure? This is quite strange—it actually grew on the liver." Lin Ge had already believed Zheng Ren's words; in his speech, he ruled out the spleen.

"Ninety percent probability." Zheng Ren said. "It's very dangerous; hurry up and do the examination, then surgery. The surgery itself isn't difficult; the difficulty lies in making a prompt diagnosis."

After saying that, he glanced at Zhou Litao and said: "Manager Zhou, go urge the blood, just say the patient needs emergency transfusion, a large amount."

Zhou Litao acknowledged and ran to make a phone call urging the Blood Bank.

"That serious?" Lin Ge exclaimed.

"The liver, spleen, etc., have rich blood circulation, low surface tension, and abundant portal venous blood from the gastrointestinal tract, which is favorable for embryonic growth."

"As the embryo grows, organ rupture may cause rapid massive bleeding; if rescue is delayed, hemorrhagic shock or even death can easily occur. The mortality risk is much higher than that of ordinary ectopic pregnancy."

Zheng Ren said firmly.

The Obstetrics Inpatient Chief was curious; even if the ectopic pregnancy diagnosis were fine, leaving the spleen occupying space undiagnosed, yet insisting on diagnosing hepatic ectopic pregnancy.

This…

She greeted Director Lin and immediately ran off.

Following up to take a look, it's also a chance to broaden one's horizons. Recently Zheng Lao Ban has been touted as almost divine in the hospital; let's see if he's really that amazing.

"Zheng Lao Ban, you've been really busy today." Lin Ge laughed.

"I'm used to it." Zheng Ren said: "When I was in Hai Cheng, I lived in the hospital every day. Coming home and finding quiet, I actually sleep less well."

This is a habit of Emergency Department doctors; working year-round in chaotic environments, once it quiets down, they subconsciously wonder if a wave of outbreaks is waiting for them.

Without making a sound, they really can't fall asleep.

Zhou Litao returned after making the call and said: "The Blood Bank knows it's an ectopic pregnancy; they've prepared 20U of red blood cells and 1000ml of plasma."

Zheng Ren felt relieved; preparations were thorough, the patient should be fine.

Normally, he would have followed up to take a look.

But right now there's a patient with congenital porphyria waiting for consultation; Zheng Ren is already somewhat eager to go to the System Operating Room to dissect a congenital porphyria patient.

Actually, calling it congenital porphyria isn't accurate; he believes the disease merely has symptoms matching congenital porphyria; in fact… Gu's ancient mysterious family is more likely to be vampires.