Chapter 3019

Soon, Information Su Yun transmitted the received image data to Zheng Ren.

It's just a few films and lab reports, but one can see the elderly person's physical condition is truly extremely poor, and the condition is quite thorny.

When admitted, ion imbalance was quite severe; now basically returned to normal, but judging from the images, Shou Bing is not something you can just do.

Zenker diverticulum is a type of pharyngoesophageal diverticulum, different from ordinary esophageal diverticulum; in 1874, German pathologist Zenker correctly analyzed and observed pharyngoesophageal diverticulum, and thus it was named Zenker diverticulum.

Pharyngoesophageal diverticulum accounts for about 60% of esophageal diverticula, and it is most commonly seen in patients aged 50 to 80.

This pharyngoesophageal diverticulum occurring at the junction of the pharynx and esophagus is Zenker diverticulum; its occurrence is related to incoordination of pharyngoesophageal muscle movement, relaxation of the cricopharyngeus muscle causing increased intraluminal pressure, and weakness in the local muscular anatomical structure.

There is no doubt in diagnosis; gastroscopy has confirmed it. What this elderly patient needs is not diagnosis or differential diagnosis; the difficulty lies in treatment.

"Boss, I think the various indicators are stable; there is a possibility of Shou Bing. But it's only a possibility, and the chance of not being able to get off the operating table is greater. With this body, it's hard to withstand the blow of Shou Bing and anesthesia." Su Yun said after looking over the lab report.

"Let me think." Zheng Ren put down his phone, gazing at the distant flashing neon lights, pondering the patient's condition in his mind.

The elderly person is already 84 years old; six years ago, progressive dysphagia was discovered, and examination diagnosed Zenker diverticulum. At that time, simply because of advanced age, the patient's family discussed and decided to refuse Shou Bing treatment.

That was six years ago; back then they refused, let alone now.

Before admission, the elderly could only take semi-liquid diet, and was accompanied by intermittent vomiting.

After admission, upper gastrointestinal contrast imaging showed a huge diverticulum on the right wall of the esophageal cervical to upper thoracic segment, its lower end reaching the level of the aortic arch, about 10 cm × 6 cm in size; the width of the diverticulum base is about 7 cm, and the length of the ridge between the diverticulum and the thoracic esophagus is about 3 cm.

Chest CT scan showed that the pharyngoesophageal diverticulum located in the thorax compresses and narrows the trachea and esophagus.

Electronic gastroscopy revealed a huge diverticulum on the right esophageal wall 16–23 cm from the incisors; the diverticulum wall mucosa is markedly congested, the esophageal lumen narrowed by pressure into a intermittently opening pore-like shape, and the gastroscope cannot pass through.

"Since the base of the diverticulum lies in the cervical esophagus and the upper thoracic esophagus, whether via a cervical incision or a thoracic incision, the diverticulum base cannot be fully exposed, making complete excision impossible." Zheng Ren recalled and said to Su Yun.

"Yes." Su Yun frowned, "The diverticulum is too large, and it is also unsuitable for diverticulum suspension surgery. At this age, it is definitely not possible to undergo a combined cervical-thoracic Shou Bing."

"Hmm, definitely not. If it's a combined incision, I'm afraid one might get off the table but not leave the ICU. I guess the Marshal's Residence side is probably considering the same, and the family's refusal of treatment also makes sense." Zheng Ren pondered.

Afterwards, silence fell in the car; Zhou Chun Yong felt quite embarrassed, Zheng Lao Ban and Su Yun were both deep in thought, and he neither wanted nor dared to disturb their train of thought.

In silence they arrived at the restaurant, Zheng Ren got out of the car and entered the private room with Zhou Chun Yong, asking the waiter, 'Excuse me, do you have pen and paper?'

'Um… yes, sir, please wait a moment.' The waiter politely went to get paper and pen.

'Boss, do you have any ideas?' Su Yun asked.

'I have a vague idea, but it's not clear yet; let me draw it out for you to see.' Zheng Ren simply didn't go up to the table, instead sitting directly on the nearby sofa, elbows on his knees, eyes slightly narrowed as he looked at the coffee table in front of him.

'What are they doing?' Director Bao quietly asked Zhou Chun Yong.

'I told Zheng Lao Ban about Peng lao's lover; it was just casual talk, I never expected him to take it seriously.' Zhou Chun Yong said helplessly.

'Is there any way?' Director Bao asked, unwilling to believe.

'I don't know, let's see.' Although Zhou Chun Yong had witnessed Zheng Lao Ban perform countless high‑difficulty surgeries, he still couldn't bring himself to believe it.

The elderly person lives in Shuai Fu; Xiehe is called the final stop in the country's medical field, Shuai Fu is a point with the strongest technical capability, yet even there there's little that can be done—Zheng Lao Ban surely can't solve the problem like a heavenly immortal flying in from afar, can he?

Could they be planning to use an interventional approach again? Zhou Chun Yong suddenly thought of this possibility. Bullet embolism—Zheng Lao Ban had used interventional means to remove the bullet. This idea seemed like a heavenly immortal flying in from afar, and even now recalling it feels astonishingly brilliant.

It's also possible that one shouldn't gauge Zheng Lao Ban by one's own standards; Zhou Chun Yong had already knelt before him early on, and his kneeling was utterly thorough.

The waiter brought the pen and paper, and Zheng Ren immediately began sketching a rough draft. From his elevated position, Zhou Chun Yong could see in the distance that it was a schematic of the neck‑chest human anatomy. Though merely a sketch, the form was lifelike, and the three‑dimensional structure was shown with shadow in great Clarity.

Zheng Lao Ban and Su Yun began discussing ideas for the surgery, and Director Bao felt especially helpless.

By rights, sitting here, whether out of courtesy or seniority, one should be given full respect. Over the course of a meal spent chatting and laughing, everyone came to know each other better, making future dealings easier.

This is the most basic idea; it seems that as long as one has a bit of emotional intelligence, one would do this.

But Zheng Lao Ban and Su Yun didn't even glance at me, chatting heatedly over there, occasionally exchanging a few sharp words, quite intense.

'Director Bao, Zheng Lao Ban is just like that.' Zhou Chun Yong sighed, 'How about we order first?'

'Wait a moment.' Bao Longtao, though slightly angry, couldn't find fault. They were thinking of a treatment plan for his own master's wife; even if he felt the family had already given up treatment and there was no need to ponder these matters, it would still be impolite to interrupt.

Actually, whether one wants to or not no longer matters; even if one were to interrupt Zheng Lao Ban, one would still have to deal with the consequences. It's said that Zheng Lao Ban's combat ability is strong—when rescuing in the ER, a sideways glance is enough to show he truly dares to strike someone.

'Not worth it, not worth it,' Bao Longtao shook his head, 'Wait a bit longer.'

He found a seat, opened a small group on his phone, saw the messages inside, and his expression darkened.

'The two elderly folks have discussed it and have already discharged themselves,' Bao Longtao said, 'They're preparing to return to their hometown.'

'Um…' Zhou Chun Yong watched Zheng Lao Ban and Su Yun engaged in heated discussion, his heart a mix of feelings.

Is their Discussion still meaningful? It's completely meaningless.

People pay attention to 'leaves returning to their roots'; many, when they pass away, want to go back to their hometown, especially the elderly.

'Director Bao, where is the hometown?'

'Over by the Fen River, it'll take some driving time.' Bao Longtao said softly, 'They're still preparing the car; expected to leave early tomorrow morning and arrive in the Evening. Tomorrow the two of us will go see them off and take another look at the elderly person.'