Chapter 2212: 2135 I have little clinical experience, don't deceive me

2135 I have little clinical experience, don't deceive me.

Bleeding? Where is the bleeding point?!

The hemoglobin has dropped this much; there must be at least 1500 ml of bleeding, which isn't just a single blood bag no matter where you put it.

Is the hemoglobin drop due to malignant tumor?

That's not likely. In mid-stage liver cancer, the chance of developing malignant anemia isn't high, and moreover malignant anemia decreases gradually, not dropping this severely in less than 24 hours.

"Is there fluid in the abdominal cavity?" Zheng Ren asked.

"No."

Gallbladder... pancreas... where is the problem?

Zheng Ren frowned, deep in thought, staring intently at the last CT scan, constantly reconstructing in his mind.

Soon, Zheng Ren found the source of the problem.

It's not the gallbladder; there's nothing wrong with the gallbladder. The problem is that a faint "muddy stone" can be seen in the bile duct.

If it were an ordinary patient, this would be normal, but Zheng Ren thought of another possibility.

"Look at the patient." Zheng Ren didn't stand on ceremony; he insisted on finding the answer himself.

The patient's hemoglobin has dropped this low; if we wait any longer, it could cost a life.

Zhao Wenhua was delighted; although he and Zheng Lao Ban were considered enemies, when faced with a difficult problem Zheng Lao Ban was willing to lend a hand, giving Zhao Wenhua more confidence.

This patient has given Zhao Wenhua a headache.

As a doctor who especially dislikes medical risk, Zhao Wenhua is conservative and obstinate. He is reluctant to try new surgical methods lightly, and even the patients he accepts are "carefully selected."

Even so, it's still hard to guarantee nothing will go wrong.

Today, we've encountered it.

Zhao Wenhua brought Zheng Lao Ban to the ward; he walked ahead, his steps becoming steadier and steadier.

The aura behind him was as steady as a mountain, and his own heart seemed less panicked than before. It was like a small boat drifting on murky water, not knowing when it might sink, when suddenly a weight was added to steady it, and it immediately stabilized.

This is exactly that feeling, which Zhao Wenhua perceived very clearly.

Alas, he regretted offending Zheng Lao Ban over a bed back then. As Zhao Wenhua walked, he recalled the past and suddenly felt disheartened.

Zheng Ren paid no attention to what Zhao Wenhua was thinking; he was busy trying to find a reason and logic for his own sudden idea.

After just a few steps, Zheng Ren grew steadier and had fully figured it out.

Entering the ward, the patient lay on the bed with a blood bag hanging from the IV stand, receiving a transfusion. His lips were pale and cracked, looking weak and listless.

And his system panel had begun to turn from blood red to pale.

The diagnosis on the system panel was clear—hemorrhagic shock, ruptured liver cancer.

Just as imagined!

"Zheng Lao Ban, the patient..." Zhao Wenhua walked to the bedside, about to introduce the condition and wait for Zheng Lao Ban to examine, but he saw Zheng Lao Ban not following in, instead standing outside waving at him.

Um... what's going on?

If it had been a while ago, Zhao Wenhua would surely have thought Zheng Lao Ban was targeting him.

Set a trap to play with him. Afterwards who knows what dirty, underhanded methods would follow.

But Zhao Wenhua still had some sense; a few days ago Zheng Lao Ban had even rubbed the experts from the UK King's Hospital into the ground—did he really have time to play tricks?

What a big heart!

He walked out, scalp tingling, under the strange, anxious gazes of the patient's family.

"Zheng Lao Ban, you..."

"I've figured it out: it's bleeding from a ruptured blood vessel during the process of necrosis and shrinkage of the tumor after radiofrequency ablation, causing the current situation." Zheng Ren said softly.

Zhao Wenhua froze instantly.

Radiofrequency ablation burns the liver tumor from the middle, destroying tumor cells. Afterward it definitely forms a scar; as the internal structure collapses, the periphery begins to shrink.

In imaging terms, the tumor shrinks after the procedure, and a small liver tumor may completely become scar tissue.

Zhao Wenhua understands all this, but bleeding occurring several days after radiofrequency ablation, while possible and logical, is highly improbable.

"Are you thinking of gallstones?" Zheng Ren asked with a smile.

"Mm." Zhao Wenhua didn't hide it, nodding in acknowledgment.

"I'll contact Director Luo to arrange an emergency gastroscopy; a look at the descending duodenum will tell us." Zheng Ren said, "Send the patient over—right, call the operating room directly to prepare for emergency hemostasis."

Zhao Wenhua immediately became a junior doctor; even if he didn't understand or agree with a superior's diagnosis, he could only nod habitually.

Zheng Ren turned around and almost bumped into Lin Yuan.

He jumped back in fright.

"Why aren't you writing the medical record? After finishing, take a break—aren't you tired from all this trouble?" Zheng Ren frowned.

He had been thinking so hard about the patient's condition that he didn't even notice Lin Yuan tagging along beside him.

"Zheng Lao Ban, how was the gallstone ruled out?" Lin Yuan asked quietly.

"That's not a gallstone; it's fresh blood." Zheng Ren said.

"Um... Zheng Lao Ban, are you saying the tumor tissue ruptured and bled, flowing backward through the bile duct into the gallbladder?" Lin Yuan pondered, still doubtful: "The imaging presentation of blood isn't like that—I have little clinical experience, don't deceive me."

Zhao Wenhua was busy and happened to hear Lin Yuan's remark. He nodded repeatedly in his heart: Zheng Lao Ban, we have little clinical experience, don't deceive us.

"You forgot why we did an interventional procedure before the radiofrequency ablation for CT localization, didn't you?" Zheng Ren said.

"Is it iodized oil?" Lin Yuan said in surprise.

"Mm, it's iodized oil." Zheng Ren said, "After the iodized oil disperses, its image mixes with the fresh blood, making the imaging appearance similar to muddy gallstones."

"Uh..." Lin Yuan still had questions, but when Zhao Wenhua heard Zheng Ren's words, the fog before his eyes cleared instantly, and he suddenly understood.

Cause and effect, thought through thoroughly.

Sometimes a single word from an immortal is enough to point the way.

"Zheng Lao Ban, I understand!" Zhao Wenhua excitedly said, "Let's go directly to the Operating Room."

"No rush, first do a gastroscopy to have a look, there are other rare possibilities." Zheng Ren said with a smile, "I'll go to the laparoscopy room first, contact by phone."

Having said that, Zheng Ren strode out.

Lin Yuan followed behind Zheng Ren, panting, his ponytail swinging back and forth.

"No need to write the medical record?" Zheng Ren didn't turn back, but took out his phone and started looking for Director Luo's number.

"Gu Xiao Ran has come, hasn't she? I'll do my work a bit later. Zheng Lao Ban, my clinical experience isn't rich, you need to teach me more." Saying that, Lin Yuan almost let out a habitual "meow".

But Zheng Lao Ban, being a straight-as-steel man, didn't hear the implied call at all, and casually said, "Oh, as long as you don't find overtime tiring."