Chapter 1947: 1879 Impossible Diagnosis

"Spontaneous esophageal rupture?" Xia Hua was stunned for a moment, then felt a strange emotion in his heart.

He immediately said: "Zheng Lao Ban, the patient didn't vomit blood after drinking; the family said when recounting the medical history that he was asleep at night halfway through, then suddenly coughed blood."

Spontaneous esophageal rupture is rarely seen; Xia Hua, after over ten years in medicine, has only seen one case. The book says that generally it is caused by vomiting due to alcohol consumption.

"Oh, sometimes when the patient's family recounts the medical history we need to examine it dialectically; it's not necessarily all correct, we need to analyze further." Zheng Ren said: "When should the patient go into surgery? If the condition is a routine thoracotomy, I estimate we can't achieve anastomosis in one stage; we'd need to talk about a second stage."

Xia Hua felt a bit annoyed; is this someone meddling with his own work?

Generally, outside experts have no time to spare; some don't even look at the patient before surgery. As soon as the vehicle that picked them up from the plane arrived, the hospital began sending patients to the operating room.

Upon arriving at the hospital, the professor went straight onto the stage.

Several hours later the surgery was done, they pocketed the money and left; some even skipped meals to catch their flight.

If it weren't for this familiar doctor's strong request, nobody would go looking for trouble at another hospital.

This person is just young, and doesn't even know the rules.

The most crucial thing is his diagnosis… which also has problems.

The cause and mechanism of spontaneous esophageal rupture are still not fully understood to this day.

Most patients first vomit, then develop esophageal perforation, so vomiting remains the most important cause of onset. There is also another saying that many doctors call it post-vomiting esophageal rupture.

Associated with vomiting is alcohol consumption; most patients who vomit do so after overeating or drinking.

Other causes of spontaneous esophageal rupture include childbirth, car accidents, post-cranial surgery, epilepsy, etc.

The patient coughed blood during sleep and had no history of alcohol consumption; these two points basically rule out spontaneous esophageal rupture.

Xia Hua felt a bit indignant, and then worried about his own grandfather's surgery.

What level is this all about?

He's too young; indeed not very reliable.

"Boss, this is a typical spontaneous esophageal rupture; can't you suture it in one stage?" Su Yun asked from the side.

"Hmm, can't suture it. If it were a complex trauma with abdominal cavity injury, opening the abdomen to take out the greater omentum for external layer suturing would be possible." Zheng Ren said: "But that's within the scope of surgery; if surgery is combined with interventional surgery, just setting up a big frame would do."

"……" Xia Hua was speechless.

It sounds just like the real thing.

And yet surgery plus interventional surgery combined therapy—clinically there's basically no such procedure, right?

This Zheng Lao Ban looks honest and simple, yet how can his speech and actions be so unreliable!

Xia Hua felt a bit annoyed inside.

But he knows Gao Shaojie's character; an elegant scholar's demeanor, Xia Hua greatly admires him.

The matter is contradictory front and back; Xia Hua feels his mind is a bit muddled.

"Xia Hua, give grandfather's films to Zheng Lao Ban to look at." Gao Shaojie sensed the atmosphere was a bit awkward, so he quickly said.

"Oh, oh." Xia Hua's movements slowed a bit.

Yesterday's newly performed upper gastrointestinal contrast study showed the esophageal tumor had almost completely blocked the esophageal lumen. After drinking the contrast agent, the fluid lingered above the tumor for ten-odd seconds before a thin line slowly trickled down.

The tumor had grown compared to before; its lateral wall nearly touched the heart.

Zheng Ren crossed his arms and seriously examined the films.

"Zheng Lao Ban, will you take me up today?" Gao Shaojie said softly.

"Hmm." Zheng Ren merely nodded, seeming not to care about Gao Shaojie's attitude.

Xia Hua became even more displeased.

He truly didn't know why Teacher Gao Gao Shaojie was hurrying to slip a note to this young doctor.

Nobel Prize? That's something so far away; Xia Hua has no concept of it.

However, seeing Gao Shaojie's excited expression, Xia Hua's doubts grew a bit more.

Faced with cold treatment, shouldn't one be angry? How could Teacher Gao be excited?

After a full five minutes, Zheng Ren said: "Old Gao, Dual Intervention Combined Therapy can be done this way."

"I knew you could do it!" Gao Shaojie shouted.

"However, today we can only make a small opening in the esophagus; afterward the stent will need to be opened 2-3 more times." Zheng Ren said: "I don't have time left; you'll do the rest."

"Okay!" Gao Shaojie promised wholeheartedly, "Then you just glance at the patient's condition, and we'll proceed?"

"Alright." Zheng Ren turned and extended his hand.

Xia Hua was stunned for a moment.

"Oh, Doctor Xia, could you lend me your stethoscope for a moment?" Zheng Ren said with a smile.

Xia Hua handed his stethoscope to Zheng Ren and took him to the ward.

Although he felt annoyed inside, at this point it was already a done deal; if he refused now, his future relationship with Gao Shaojie would be unnecessary to manage.

Others came to help, yet he himself ended up backing out—there's no justification for that.

Xia Hua felt some regret.

"Right, Doctor Xia, the patient with spontaneous esophageal rupture just now—let's get him into surgery quickly." Zheng Ren said: "The later it is, the more edema at the rupture site worsens, and postoperative recovery becomes poorer."

"……" Xia Hua didn't speak, head down, trying to hide all his dissatisfaction.

Gao Shaojie noticed a hint; he waited for Zheng Ren to enter the ward and begin the physical exam, then lightly patted Xia Hua's back, gave a glance, signaling him to go out with him.

"Xia Hua, are you just too tired?" After leaving the ward, Gao Shaojie asked softly.

"Teacher Gao..." Xia Hua hesitated a bit, paused, then said: "Is this Zheng Lao Ban really that skilled?"

"Of course he's skilled, and not just ordinarily so." Gao Shaojie laughed softly: "Whether it's surgery or diagnosis, it's beyond what we could imagine. Are you thinking differently just because he's young?"

Xia Hua remained silent.

Gao Shaojie chuckled: "Old Liu now works as a little doctor under them, supposedly exhausted like a dog every day."

Xia Hua knows this, but he just doesn't understand it.

"Teacher Gao, I'll tell you the truth. I don't know Zheng Lao Ban's level of involvement. But the films just now show the patient had no triggering factors for spontaneous esophageal rupture; I'm considering tumor erosion causing a bronchopleural fistula."

"You misdiagnosed." Gao Shaojie said softly.

He looked at Xia Hua's expression, knowing he had something on his mind. Gao Shaojie is modest in character, but he is not the kind of person who is single‑minded.

After thinking, Gao Shaojie smiled and said, "Who's on duty?"

"The Operating Room has an emergency major car accident; they estimate they won't be able to get off the operating table before four this Afternoon."

"Then just find any doctor, you two go up and open the chest for exploration. Can the surgery be done?" Gao Shaojie asked.

Xia Hua nodded, thinking this plan was not bad.

His own grandfather's condition is not an emergency; a few hours can still be waited.

"Let Zheng Lao Ban go to the Observation Platform?"

"You could also let him lend you a hand." Gao Shaojie smiled.