Chapter 560: 551 What Are You Looking At

Cheng Lixue was furious!

He's shooting himself in the foot!

The patient's cirrhosis diagnosis is clear; looking at the films, the ascites volume is also large—how dare he say my diagnosis is wrong?!

Cheng Lixue stared hatefully at Gao Shaojie; it must be because of this medical university professor, it must be!

Immediately, he glared at Zheng Ren, barely suppressing his anger, and said: "Chief Zheng, I believe the diagnosis is clear."

As soon as he spoke, a rush of blood surged to Cheng Lixue's head; he angrily pointed at the film on the viewer and said: "The symptoms of cirrhosis are obvious, portal vein pressure is high, there's massive ascites! I don't know why Chief Zheng says my diagnosis is wrong—does he not want to be my patient?!"

The last sentence was somewhat heartless.

Having said that, he had already torn all pretense.

This meant that there was no longer any possibility of cooperation between Cheng Lixue and Zheng Ren.

But!

Cheng Lixue couldn't bear it!

If this can be tolerated, what cannot be!

Damn it, he actually refuses to be my patient!

Director Zhang's expression changed, he stepped forward half a step, blocking Cheng Lixue and Zheng Ren.

Just as he was about to speak, he heard Zheng Ren say leisurely: "Director Cheng, haven't you examined the patient?"

"Huh?" Director Zhang froze for a moment.

Cheng Lixue's face flushed red, he was also puzzled: how did Zheng Ren know he hadn't examined the patient?

But how could he admit that!

He thought Zheng Ren was deliberately throwing dirt at him; it was impossible for him to know he hadn't examined the patient.

Exactly! He's not a fortune-teller—how could he know he hadn't seen the patient?

This idea made sense.

Thus, Cheng Lixue became even more furious!

His anger made his hair stand on end.

But before he could speak, Zheng Ren asked Wang Qiang for a pen, lightly pointed at the film, and said: "Looking at the film, it indeed looks like cirrhosis, splenomegaly, and is of late-stage form."

Cheng Lixue let out a cold snort.

"But Director Cheng, have you noticed that the patient's liver hasn't shrunk; instead, it has enlarged?" Zheng Ren asked.

"..." Cheng Lixue hadn't even examined the film closely; the liver not shrinking seemed normal...

Of course, Cheng Lixue also knew this wasn't normal. Although he said that, such rare cases occasionally appear.

Cheng Lixue increasingly felt that Zheng Ren was adding to his guilt.

"This isn't cirrhosis, but Budd-Chiari syndrome." Zheng Ren sighed, saying: "Budd-Chiari syndrome, caused by various factors leading to occlusion of the hepatic veins and the suprahepatic segment of the inferior vena cava, results in a post-sinusoidal portal hypertension characterized by elevated inferior vena cava pressure."

"It looks similar to cirrhosis; misdiagnosis is possible, but usually only hospitals below county level make such mistakes—Director Cheng, how could you miss it? That shouldn't happen."

Zheng Ren's tone was flat, as if talking to himself, without blame, only questioning.

But each sentence felt like an invisible big hand slapping Cheng Lixue's face.

"You... impossible!" Cheng Lixue stubbornly argued.

"Director Cheng, if you had personally examined the patient, you would surely have noticed the spider-man signs, with dilated abdominal surface Veins and boot-shaped necrosis of both lower limbs. These would clearly tell you it's not cirrhosis." Zheng Ren's tone remained flat.

But the slap grew more intense.

Professor Rudolf Wagner curled his lip, looking down on Cheng Lixue.

Director Kong stood smiling at the back; he had already figured it out, but as merely a guest consultant, if Zheng Ren overlooked it, he would just whisper a reminder when no one was around.

But without a doubt, Zheng Ren had figured it out.

Gao Shaojie had a blank expression, coldly looking at the film.

If this were Gao Shaojie's subordinate doctor, or even if Wang Qiang showed him a Budd-Chiari film claiming it was cirrhosis, Gao Shaojie would have long since smashed the film onto the doctor's face.

One can be ignorant, but not even looking at the patient is going too far.

Seeing Cheng Lixue's face flushed red and unable to utter a word, Director Zhang guessed he really hadn't examined the patient.

He hurried to smooth things over, saying: "Teacher Zheng..."

"Let's go take a look at the patient." Zheng Ren said: "Before interventional surgery, Budd-Chiari syndrome is almost untreatable; but with interventional surgery, it's no longer a difficult problem."

"Interventional surgery entering clinical practice is one of the most typical diseases; Director Cheng really shouldn't be unaware of it." Zheng Ren shook his head, looking at Director Zhang.

Director Zhang also felt helpless, asked which ward the patient was in, and brought Zheng Ren to see the patient.

The patient lay on the hospital bed, abdomen distended, limbs Bone-thin like firewood, typical cachexia. Because the abdomen was distended and the limbs were Bone-thin like firewood, it resembled a big-bellied spider with only four legs, lying on the bed.

In a daze, there was a surreal feeling.

Zheng Ren glanced at the system panel in the upper right of his vision; the diagnosis it displayed matched his own film reading—Budd-Chiari syndrome.

After greeting the patient and family, Zheng Ren began a personal examination.

He lifted the patient's abdominal clothing; three Veins about 1 cm in diameter writhed like small snakes across the belly skin.

The symptoms matched exactly what Zheng Ren had judged in the office, with no discrepancy.

All the doctors fell silent.

Zheng Ren performed percussion, confirming ascites and the liver area; then he began examining the patient's feet.

A pair of purplish feet appeared before everyone.

They were ischemic, but not yet necrotic; even so, it was serious.

Zheng Ren asked a few more medical history questions, then led everyone out of the ward back to the office.

"Typical spider-man signs, and boot-shaped deformity of both lower limbs due to venous reflux are also clear." Zheng Ren returned to the film, pointed at it, and said: "Therefore, the patient's diagnosis of Budd-Chiari syndrome is quite certain."

Cheng Lixue's face was red as if about to bleed.

"Director Cheng, I recall that a few days ago you went to City First Hospital and said you wanted to learn TIPS Surgery, right?" Zheng Ren said.

Silence, a vast silence.

"Nuclear Magnetic Resonance diffusion is hard to understand, no problem. Even using Nuclear Magnetic Resonance diffusion to assess the relationship between the portal vein and hepatic vein blood vessels in late-stage hepatic cirrhosis is also difficult." Zheng Ren looked at the image, his tone flat, "But as a doctor, as a director, not looking at the image before surgery, not looking at the patient, that's going too far!"

Cheng Lixue was speechless, he lowered his head and stepped back a few steps.

"Teacher Zheng, can this patient undergo the Shou Bing?" Director Zhang asked.

"Manager Feng, do you have Blood Vessel consumables?" Zheng Ren asked.

"Thrombolysis? I brought it, just preparing for you to do thrombolysis." Feng Xu Hui said happily.

"No need for thrombolysis, an ordinary guidewire can do it." Zheng Ren said.

Cheng Lixue suddenly lifted his head, his eyes filled with bloodshot lines, his lips twitched, as if wanting to say something.

Professor Rudolf Wagner glared at him and said, "What are you looking at?"