Chapter 2227: 2150 Flirtatious Operation

Feng Xu Hui was startled by Su Yun's words.

Isn't the diagnosis clear? Although I'm not a doctor, Feng Xu Hui knows about adrenal crisis. The illness is serious and urgent, that can be affirmed. But the Medical University Affiliated Hospital has high medical standards, which cannot be denied, so the person should be fine.

But Yun Ge'er said the matter is serious!

"The seemingly reasonable diagnosis is that renal vein thrombosis causes adrenal crisis, and there's also a hematoma from bleeding. It's too coincidental, like diagnosing acute appendicitis in a boy with transferred right lower abdominal pain—there's nothing to think about."

Feng Xu Hui stared blankly at Su Yun; when it came to the patient's history, symptoms, objective examination, and final diagnosis, he couldn't insert a word.

"If nothing happens, it's fine; but if something happens, it's a big deal."

"For example?"

"For example, renal vein thrombosis can be said to be caused by oral contraceptives. We've seen such patients before—it was that Medical University student who fell." Su Yun said while gesturing.

While explaining the condition to Feng Xu Hui, Su Yun was also organizing his thoughts.

Feng Xu Hui remembers this operation; Zheng Lao Ban removed a 12cm clot, and he still recalls it vividly.

"But it's too coincidental; looking at it makes me uneasy." Su Yun smiled.

Yun Ge'er's judgment is too idealistic. Feng Xu Hui somewhat doubts it; he still thinks adrenal crisis alone is enough.

"The patient has had recurrent orthostatic fainting for seven days, developed hyponatremia, the adrenal crisis diagnosis is clear, and low blood pressure is the main cause of fainting." Su Yun chatted casually, "Well, hyponatremia is what you said, and it's not obvious, so this diagnosis doesn't count for now."

"Adrenal cortical insufficiency leads to adrenal crisis; common causes of primary adrenal cortical insufficiency include adrenal tuberculosis, fungal infection, solid tumors, and autoimmune diseases, etc."

"I guess the Medical University Affiliated Hospital side also needs to check each possibility."

Su Yun chatted up to this point, then stopped; saying more would be meaningless, just wasting breath.

Everything must wait until we see the limited test results before speaking.

Professor Zheng Renhe and he performed the surgery together; the speed wasn't fast. Because the professor was leaving, Zheng Ren was especially conscientious, repeatedly correcting each problematic step.

After the surgery finished, Zheng Ren walked out of the operating room, and Lin Yuan's side transmitted various data over.

Su Yun pulled Lin Yuan into the group; the moment he entered, Chu Yanran's avatar began to flash.

A string of welcoming words made Lin Yuan feel that seeking help from his own father this time was absolutely worth it.

Only after joining the group does one count as one of our own.

She hurried to upload the data, then watched Gu Xiao Ran escort patients away, brushing up and down during a surgery.

"There's no major issue with the blood tests," Su Yun and Zheng Ren said.

"Cortisol 0.74 mg/dl, ACTH 356 pg/ml, thyroid function normal; supine RAAS shows plasma renin activity 3.29 ng/(ml·h), aldosterone 59 pg/ml; upright RAAS shows PRA 6.37 ng/(ml·h), ALD 78.1 pg/ml."

He pointed out the problematic items; Zheng Ren merely nodded, seeming to be in thought.

Besides that, the enhanced abdominal CT results matched Zheng Ren and Su Yun's judgment—bilateral adrenal diffuse enlargement, sizes 3.2×3.4 cm on the left and 2.5×4.9 cm on the right, clear borders, uneven density.

CT values ranged 36–65 HU; the enhanced scan showed no clear enhancement, making adrenal hematoma likely.

The left renal vein is dilated, with an irregular low-density focus inside the lumen about 2.3 cm long; the right renal vein also shows a low-density patch about 0.8 cm long, suggesting thrombosis.

"Boss, do you see the problem?" Su Yun asked when Zheng Ren remained silent.

"The case says the patient has pigmentation," Zheng Ren said.

The physical examination at the Medical University Affiliated Hospital was very detailed, describing pigmentation in the supraclavicular fossa, axillae, waist and abdomen, auricula, both palm prints, dorsal skin of the index finger, lips, and oral mucosa.

Scattered herpes lesions are visible on the left nasal ala; bilateral jaw skin shows pigmentation with scattered papules, some surfaces ulcerated.

These were not described by Feng Xu Hui.

"I've seen it; tuberculosis and adrenal fungal infection are not considered..."

"Not considered either," Zheng Ren said firmly.

"Adrenal tumors have also been ruled out, so it's likely an autoimmune system disease." Su Yun laughed, "We should go see Big White."

"No need, the condition... I'll think again." Zheng Ren said.

"Everything that can be ruled out has been; I guess it's antiphospholipid syndrome."

"Yeah, secondary." Zheng Ren added.

"Any ideas for treatment?"

Zheng Ren thought a moment, then began discussing with Su Yun.

This time it was a very professional conversation; Feng Xu Hui couldn't keep up from the start.

In the conversation between Zheng Ren and Su Yun, each term required much thought; before I could even grasp the first sentence's meaning, Chief Zheng and Yun Ge'er had already reached the tenth sentence.

Forget it; Feng Xu Hui gave up trying to figure it out with his brain, just needing Chief Zheng and Yun Ge'er to give an answer.

Just watching the two discuss the condition was still quite interesting.

Chief Zheng is still the Hai Cheng Chief Zheng, honest and simple-spoken, speaking in a measured way like an elderly professor, citing classics. Yun Ge'er hasn't changed either; if he doesn't retort Chief Zheng in a few sentences, he feels uncomfortable all over.

The two were like arguing, speaking for nearly half an hour; Xie Yiren was used to it, not listening to what they said, just staring at the surgery inside.

After one surgery ended, they were still arguing; apparently they were extrapolating from current test results to predict possible, unreported tests.

This is inhuman operation; Feng Xu Hui felt somewhat dazed, wondering if this was right.

After the surgery ended, during the intermission, Chief Zheng explained the operation to Fugui'er. Meanwhile, Yun Ge'er found pen and paper and began writing.

Faced with Su Yun's flamboyant operation, Feng Xu Hui completely didn't know what he was doing.

Thus, time flew by as Zheng Ren and Su Yun debated the condition and watched the surgery.

After the final surgery, Su Yun held a stack of papers and laughed, saying, "That's it; the diagnosis is secondary antiphospholipid syndrome."

"Hmm."

"Secondary antiphospholipid syndrome, with likely systemic lupus erythematosus, bilateral adrenal vein thrombosis leading to adrenal hematoma; primary adrenal cortical insufficiency; adrenal crisis."

Su Yun spoke while writing, his forehead black hair fluttering, looking extremely pleased.

After Su Yun finished writing, Zheng Ren took a look, adding a smiley face at the end.

"Boss, they all say what you're doing is useless."

"I'm used to it." Zheng Ren smiled and handed over a dozen A4 sheets to Feng Xu Hui.