Chapter 2233: 2156 22‑Year‑Old Old Patient (Alliance Leader - Stopped Beating - Bonus Chapter 1)

Zheng Ren didn't know that so many things had happened at the Capital Medical University Affiliated Hospital.

He had lunch with Yi Ren, then returned to sit by the window in the Intervention Department.

The afternoon was peaceful and sunny; sitting in the sunlight with the Fifth Edition of External Medicine on his lap, he leisurely went to the System Library to read.

A quiet, peaceful life is wonderful; if it could always be like this, how great would that be.

Zheng Ren sat by the small pond in the System Space, quietly reading a magazine with his feet in the water; when he felt happy, he twitched his feet slightly, sending out little ripples.

"Boss, come look at the images!" Su Yun's voice came from outside; Zheng Ren reluctantly gave up his moment of leisure and left the System Space.

"What patient?"

"I was just wandering around, and Fang Lin admitted a pneumothorax patient over there," Su Yun said.

"What's there to see about a pneumothorax?" Zheng Ren lost interest as soon as Su Yun finished speaking.

Whether traumatic or spontaneous, a pneumothorax is a pneumothorax. General anesthesia, single-lung ventilation, locate the bulla or lung laceration, suture it, and that's it.

Now thoracoscopic surgery is even simpler—just place a titanium clip at the breach. The procedure takes no more than an hour, including anesthesia and wake‑up time.

The only thing to watch for is recurrent lung expansion; check whether the air leak is coming from just one spot. If something is missed, a second thoracotomy might be needed, which would be hard to explain.

"This pneumothorax is strange; Fang Lin isn't sure, so have me take a look," Su Yun said with a laugh.

Zheng Ren noticed his expression change and felt a stir in his heart.

Why would Su Yun come to me with a thoracic versus general surgery issue? Back in Hai Cheng I once did a case where the films showed no lung compression, yet the lung rupture was actually quite severe.

For such rare cases, Su Yun only calls on me to take the blame when he's unsure.

"What patient?" Zheng Ren asked.

"Recurrent pneumothorax; the last episode was twenty days ago, treated locally, but air remained, so he came to the capital," Su Yun said.

"And the images?"

"Fang Lin sent over one image on his phone—nothing much to see—let's go take a look," Su Yun said, pulling Zheng Ren along.

"Recurrent? Spontaneous pneumothorax?" Zheng Ren wondered.

"Yeah, over two years it's happened seven times." Su Yun said, "Boss, don't you find that odd?"

"I do—it's very strange," Zheng Ren mused.

Spontaneous pneumothorax refers to rupture of lung tissue and the visceral pleura due to lung disease, or spontaneous bursting of subpleural bullae or tiny emphysematous cysts, allowing air from the lung and bronchi to escape into the pleural cavity.

Usually, young men aged fifteen to twenty‑five are prone to spontaneous pneumothorax.

Especially high‑schoolers; when I recently returned to Hai Cheng I met a mother who insisted on an appendectomy for her child, and Su Yun used this example to scare her.

Actually, that wasn't a threat—just stating the facts.

In a young boy, a ruptured bulla used to require a big thoracotomy to suture the bulla; now with thoracoscopy we just make two ports.

And this recurrent case before us means that the surgeon who operated previously didn't remove all the bullae.

Some patients' lungs are studded with bullae—at least a dozen or several dozen—you can't just resect the whole lobe, can you?

Moreover, the last surgery showed an abnormality, with continuous air drainage from the chest tube postoperatively.

This problem is comparatively serious.

Upon arriving in thoracic surgery, Fang Lin was reviewing the images while a man in his forties, medium build but quite overweight, stood beside him.

"Boss Zheng, Brother Yun, could you two take a look?" Fang Lin greeted Zheng Ren and Su Yun as they entered, saying, "This is my lifesaver, Boss Zheng, and this is Brother Yun."

He introduced Zheng Ren and Su Yun to the fat man beside him.

Then Fang Lin said, "This is Doctor Shao from L City."

Zheng Ren nodded, giving the chubby man a kind smile to indicate he understood.

"Huh? Is that the hospital that wanted you to do the surgery?" Su Yun asked with a chuckle.

"It wasn't earthquake relief—our hospital went to the front lines, so I only went to Old Shao's hospital for one procedure," Fang Lin explained with a laugh.

Flying knife consultations are usually done by professors heading out; hardly anyone calls the Inpatient Chief. Fang Lin, being highly skilled and faced with special circumstances, made this one trip.

"Brother Yun, how did you drag Boss Zheng over here?" Fang Lin said a bit embarrassed, "I just thought the case looked simple, but there might be a problem, so I asked you to take a look."

"Don't be so polite, and it's no trouble," Zheng Ren said with a smile, walking to the viewbox.

The images are CT; they look simple—a left pneumothorax with a chest‑tube shadow, and about ten percent lung compression.

There are abnormal shadows on the lung surface and costophrenic angle; Zheng Ren guessed they were due to prolonged intubation—either reactive hyperplasia or infection‑related exudate.

"How is the patient?"

"Zheng… Boss, hello, I'm Shao Jinghe." The chubby doctor gave an honest greeting.

Zheng Ren found it funny; if the guy were a bit sharper, after Fang Lin's introduction he'd have come forward to shake hands and get friendly.

He doesn't know whether he's been knocked down by a medical accident or if he's just like this—actually taking a few extra steps to say hello.

"Doctor Shao, no need for formalities—tell me about the patient's condition," Zheng Ren said with a smile.

"This is an old patient, twenty‑two years old, female."

"……"

"Twenty‑two‑year‑old old patient" sounds odd when said aloud, but Zheng Ren and the others knew what Shao Jinghe meant—an "old patient" meaning someone who frequently deals with the hospital.

"Two years ago the patient suddenly felt chest tightness and shortness of breath, got a chest X‑ray that showed a right‑sided spontaneous pneumothorax, and I performed a thoracoscopy. Post‑op recovery was good, and he was discharged home."

"Then, over these two years, the patient has had intermittent flare‑ups."

Shao Jinghe said this while feeling somewhat gloomy.

"Old Shao, did you miss a bulla?" Su Yun asked, looking at the images.

"I always check carefully during each operation and find nothing abnormal," Shao Jinghe said with a mournful face, "Brother Yun, do I also call you that?"

"Whatever works," Su Yun replied with a smile. This old Shao still has some sense; let's help him well.

"Whenever I see this patient now I just want to hide… my coworkers laugh at me, saying I must have done something to that girl, why won't she leave me alone?"

Zheng Ren glanced at Shao Jinghe's big belly and found it funny.

However, this kind of emotion is normal; in the previous two years, I underwent six or seven Shou Bing. Although the adhesions of lung tissue in thoracic Shou Bing are not as severe as in the intestines, opening it up is still enough to give a headache.

This doesn't even count; anyone who has worked in thoracic surgery knows that being able to perform two or three lung bullae resection Shou Bing is considered rare. This kind, having done seven in two years, who wouldn't want to avoid it?