Chapter 2095: 2022 Rare Adult Floating Liver (Monthly Ticket 64500 Bonus Chapter ×129)

"Hurry up! Chatting with the doctor here, do you have any public decency? If you're on good terms, you go drink at the bar after work—what are you pulling here?" Zheng Ren flung his hand, throwing the shackles of morality onto the patient's family.

They were stunned for a moment, then also calmed down.

The patient's stomach hurt badly, suffering during the CT. Because of this, one CT wasn't enough; they needed two more, which caused their dissatisfaction.

This kind of noise is unconscious, belonging to sporadic incidents.

After being shouted at twice, that anger and gall vanished, and the whole person calmed down.

Plus Zhou Litao has a good temper, constantly explaining, they hurriedly went with the doctors of Jizhen Wai Ke into the room to write out orders.

Zhou Litao wiped his sweat, gave Zheng Ren a look, intending to bring Zheng Ren into the main machine's duty room.

But Zheng Ren didn't go; he walked straight to the door of the Jizhen Wai Ke consultation room, urging repeatedly.

The doctors wrote out orders at lightning speed, and the patient's family hurriedly left in a small trot.

Su Yun saw the patient's family disappear, entered the Jizhen Wai Ke consultation room, gave a thumbs-up, and praised: "Boss, your acting is not bad, quite good."

Zheng Ren smiled, "Let's go, let's talk in Manager Zhou's duty room."

If the patient's family turns back over something, things might get bigger.

For such minor friction that doesn't count as a medical dispute, Zheng Ren is experienced.

After all, as the Inpatient Chief of the Emergency Department, he's seen many small ripples.

Arriving at Zhou Litao's duty room, Zheng Ren finally relaxed completely, sitting happily in the chair.

"Manager Zhou, go up and refute him." Su Yun sat directly on the bed, smiling and saying.

"I wouldn't dare." Zhou Litao said with a worried, bitter face; he knew Su Yun was joking, but the joke wasn't funny at all.

Everyone being doctors, aware of the earlier awkward topic, consciously spoke of new things.

"Manager Zhou, what's the patient's condition?" Su Yun asked: "Floating liver is usually discovered in childhood; how did the patient drag it to now?"

"When the patient came, we asked about the medical history; it's said that intermittent abdominal pain started at five or six years old, but it would soon get better." Zhou Litao said, "The family didn't pay attention, thinking it was just the girl's weak constitution."

"Later the patient got used to it; whenever it hurt, lying on the right side would make it slightly better."

"On the right side, that's the rhythm of using posture to reduce the liver."

"Pretty much; each time the stomach hurts, they find a lump that can be moved by pushing with a hand." Zhou Litao said.

"This…… Zheng Ren felt helpless. The patient is really bold, discovering such a large lump on the abdomen, yet still not coming to the hospital for a check?"

"No, it should be……"

Zheng Ren thought, while Su Yun already asked: "Has the patient never come to the hospital for a check?"

"They said they'd been checked twice; whenever the abdominal pain eased, they'd remember to get checked, but nothing turned up, so the patient gradually forgot about it."

"Forgot,"

"Forgot!"

"This time the patient's pain lasted long, lying on the right side didn't help, the upper abdominal lump was especially large. Plus nausea and vomiting, the pain was severe, so they got scared, called 120, and an ambulance brought them to the hospital."

"After they arrived, I palpated; the patient's abdomen had no tenderness, but I could feel a lump moving from right to left."

"What were you considering at that time?" Su Yun asked.

"Without tests, what could I consider?" Zhou Litao chuckled, "But I had pondered things like accessory spleen and liver malformation."

"How serious is the intestinal obstruction?" Zheng Ren asked.

"I listened, and bowel sounds were still audible, just a bit weaker, about once per minute." Zhou Litao's physical exam was very detailed, leaving nothing to criticize.

"Alright, then let's look at the films and send straight to surgery." Zheng Ren smiled: "Adult floating liver is truly rare. Terrier and Auvray first reported it in 1897; since then there's been no proper summary, and even case reports are few."

"Yeah, as long as it's mainly in children, under five years old." Su Yun added.

Zhou Litao knew that these two in front of him sounded knowledgeable, but they were also seeing this for the first time.

"What is skill?"

"This is skill."

"Remembering what you read in books is good memory; but being able to use it in clinic, as if you'd seen many cases, that's real skill!"

"Some things, some people, you just can't not accept."

Zheng Ren called Liang Boshi; that side said the check was almost done, and the left lateral position film had already been uploaded.

Opening the computer, pulling up the patient's imaging data, one can see the colon entering from the hepatic retroperitoneal space between the liver and diaphragm.

The imaging is quite typical, and compared to the supine film, the liver's floating distance shifted leftward by about 10 cm.

This is the source of the lump the patient reported feeling, and also the cause of the intestinal obstruction.

It's not completely blocked, nor strangulated or necrotic; the patient's condition is in a controllable stage.

After viewing the films, the right lateral position film was transmitted up.

After changing position, the liver's position shift is clearly visible, directly returning to its original location.

But the intestinal tract is under pressure, and the film shows some artifacts; likely due to the intestinal obstruction, the patient experiences obvious pain and agitation when lying on the right side.

"Okay, send to surgery to prepare for emergency surgery." Zheng Ren turned off the imaging data.

"Send to hepatobiliary?"

Zheng Ren glanced at Su Yun, smiling: "As Yun Ge'er said, send to hepatobiliary, call gastroenterology to come up together. First gastroenterology does intestinal reduction, then hepatobiliary fixes the liver."

"Don't make me take the blame." Su Yun said: "It's all your say-so, the troublesome stuff—I never do that."

"This disease is actually quite simple; it's just that nobody has seen it before, so everyone is a bit vague."

"It stems from overly long, weak, deficient ligaments and other developmental abnormalities that prevent the liver from fixing. When the patient stands, the liver descends, the hepato-diaphragmatic gap widens, the colon slips in causing obstruction, subsequently producing worsened pain, nausea, vomiting, and a series of clinical symptoms."

"Manager Zhou, let a surgery doctor accompany you." Zheng Ren instructed, "Don't let anything happen on the way."

"Okay." Zhou Litao walked out of the duty room, called out the surgeon who was conducting the physical exam, and gave a few instructions.

Subsequently, Zhou Litao entered the surgery emergency room to handle the patient previously undergoing examination.

Zheng Ren came out smiling, following Zhou Litao. He glanced at the surgery consultation room and immediately stopped.

"Boss?" Su Yun followed behind, walking, didn't expect he suddenly stopped, almost bumped into Zheng Ren's back.

Zheng Ren didn't speak, hurriedly rushed back to Zhou Litao's Zhibanshi, grabbed a White Coat and put it on.

"What hysteria are you causing?" Su Yun, standing at the doorway, asked him.

"Have Manager Zhou prepare Nitroglycerin, keep it quiet, don't add pressure to the patient." Zheng Ren said solemnly.