Chapter 2052: 1981 Concealed Medical History (Monthly Ticket 60500 Bonus Chapter ×121)

A diagnosis that doesn't even exist?

Lin Yuan stared for a moment, what's going on?

She was about to ask, but seeing Zheng Renhe and Su Yun not explain at all, they just walked away.

"Hey, Zheng Lao Ban!" Lin Yuan shouted from behind.

"Huh?" Zheng Ren didn't even turn his head.

"Why say a diagnosis that doesn't exist? Aren't you afraid someone will point out the mistake during the hospital consultation?" Lin Yuan said anxiously.

"You mean slapping me in the face?" Su Yun said with a hint of contempt, glancing sideways at Lin Yuan with a wicked look.

Uh……

Lin Yuan suddenly developed sinus tachycardia, which turned into atrial fibrillation.

"Zheng Lao Ban, do I really have to say this?" Yu Zong asked cautiously.

"Of course." Su Yun said with a chuckle: "But Yu Zong, do you know why?"

Yu Zong shook his head.

"The patient's heart shows calcification; considering a past undisclosed medical history, maybe they deliberately hid it, or maybe too much time passed and they forgot." Zheng Ren said.

"I think the possibility of deliberately not saying it is higher." Su Yun said.

Yu Zong was dumbfounded; Zheng Lao Ban and Yun Ge'er's diagnostic opinions were so consistent, even stating so definitively that the patient had concealed medical history.

This…… is too terrifying, right.

"Why say that?" Lin Yuan caught up, asking seriously.

"How old are you, still gnawing your fingers? You're just a little brat." Seeing Lin Yuan biting his fingers while pondering the condition, Su Yun lashed out directly.

Having endured all day yesterday, Su Yun felt the little beast deep inside his heart stirring, ready to move.

"Don't bite your nails in the hospital, it's unhygienic." Zheng Ren glanced over and said with a chuckle.

"Zheng Lao Ban, why are you so sure the patient concealed their condition?" Lin Yuan said without embarrassment, all her thoughts focused on the patient's condition.

"Because there are no auxiliary tests that clearly point to the patient possibly having hematuria." Zheng Ren said casually.

"Zheng Lao Ban, please explain in more detail." Yu Zong said with a worried frown: "In the hospital-wide consultation, you can say that, but I can't."

What he said was the truth; since Zheng Ren said it, everyone should take it seriously. But if Yu Zong were to say it when presenting the medical history, he'd get scolded.

"Taking everything into account, the patient has pericardial constriction, which is certain. Although not severe, it intermittently triggers restricted ventricular diastolic expansion, reduced ventricular diastolic filling, decreasing cardiac output. At the same time, venous return from the superior and inferior vena cava is obstructed by the pericardial constriction, raising venous pressure, causing jugular venous distension and hepatomegaly."

"……" Yu Zong still didn't understand.

"Are you saying to explain all the patient's clinical manifestations with a monistic theory of constrictive pericarditis?" Lin Yuan frowned.

"Hey, still a monistic theory?"

"Isn't it?" Lin Yuan asked.

"Of course not, it's just to scare the patient." Su Yun blew a breath, his black hair fluttering proudly above his forehead.

"Why?" Lin Yuan became even more confused.

"Because the patient has a concealed medical history." Zheng Ren said, "Come on, Yu Zong, let's go to your duty room to explain in detail."

Yu Zong let out a sigh of relief; he really feared that Zheng Lao Ban and Yun Ge'er would leave things unclear and just drop it.

Lin Yuan followed, full of doubts, back to Yu Zong's duty room. After Zheng Ren sat down, he said: "Yu Zong's judgment is correct; the patient themselves is concealing their medical history in order to hide the truth of the hematuria."

"But why would they do that?" Yu Zong asked, confused.

"Why? That's the answer you're looking for; it has nothing to do with the boss." Su Yun said.

"But..."

"Didn't we just say the patient has mild pericardial thickening, which can be diagnosed as constrictive pericarditis but won't have serious consequences?" Zheng Ren said, pointing to the chest CT just taken.

Yu Zong and Lin Yuan silently looked at the image.

"With changes in the body's external and internal conditions, such as increased thoracic or mediastinal pressure, it's equivalent to a sudden worsening of constrictive pericarditis."

Zheng Ren spoke at length; Yu Zong gradually understood his meaning, while Lin Yuan frowned and said nothing.

"As Lin Yuan also said earlier, the clinical symptoms of constrictive pericarditis include increased venous pressure in the lower limbs, leading to bilateral lower limb edema, etc. At the same time as portal pressure rises, renal venous pressure also increases, and rupture of the renal pelvic small veins causing bleeding could be related to hematuria."

After hearing Zheng Ren explain it from the beginning, Yu Zong excitedly clapped his hands and said: "I knew something was off!"

"Mm, you and Director Liu should say it like that." Zheng Ren smiled: "There shouldn't be any mistake. Thoracic pressure is easy to control; mainly the patient's heart has mild changes, and when thoracic pressure rises, signs of severe constrictive pericarditis appear. This also explains why the patient refused to give a detailed medical history—just why they did that, you'll have to ask them yourself."

"What if the patient firmly refuses surgery?" Yu Zong asked.

"Actually, surgery isn't needed at all; we're just scaring him so you can get the truth out of him." Su Yun said, "Or scare his son to get the truth."

Yu Zong let out a breath and nodded.

"Then we'll head down; if you have any progress on this side, just get in touch." Zheng Ren said, making a phone-call gesture.

"All right!" Yu Zong happily saw Zheng Ren off.

All the way downstairs, Lin Yuan still hadn't figured it out.

"Zheng Lao Ban, why are you so sure the patient is faking illness?" Lin Yuan asked.

"Do you know why the boss came to the capital?" Su Yun countered.

"It's because of the Nobel Prize project." Lin Yuan still knew that.

"No, it's because he has X-ray vision, peeking at a young widow bathing in Hai Cheng, and got chased away."

"..."

"Don't mess around." Zheng Ren quickly stopped Su Yun's nonsense: "You've also seen the earlier films and other lab tests—any clear diagnosis?"

Lin Yuan shook his head.

"Exactly, all clinical exams and signs don't support the symptoms, so there must be some other factor interfering." Zheng Ren said: "Back in the States, haven't you ever encountered someone pretending to be sick while still employed, getting a full checkup to defraud insurance?"

Lin Yuan felt a bit embarrassed, she shook her head blankly: "I'm just a graduate student, assisting the boss's work, I haven't even been an intern doctor seeing patients. Medical license……"

"Boss, look, I'm just saying she's a total newbie." Su Yun said contemptuously.

"They all came from being rookies." Zheng Ren walked downstairs, "This kind of thing is very common clinically; for example, when I was in Hai Cheng before, I left the Emergency Department."

"Not when you were the Inpatient Chief?"

"No, it was during my rotation." Zheng Ren said: "One day a female patient with abdominal pain came; I ordered the relevant tests, including a urine early pregnancy test slip, and the result was positive. The patient objected and demanded a repeat test."

"What happened then?" Lin Yuan asked, puzzled.

The results all came out; is a repeat test meaningful? Clinical lab errors do exist, but they are extremely rare.