On the film, the patient does not have a spleen.

If it is left in place, a scar tissue can be faintly seen.

"Well, I guess I did a splenectomy. Zheng Ren then asked, "Who are you?"

"It's my lover. The middle-aged man replied cautiously.

"How many years ago was splenectomy done?" asked Jung-in.

"Twenty-two years ago, I had a car accident and had my spleen removed. The man replied immediately.

Generally, when doctors watch films, the first question they ask is about splenectomy, not a mirror person, nothing special.

Zheng Ren continued to watch with his cheeks raised, and the professor stood behind him, also reading the film intently.

It's been a long time since I've watched a movie with my boss, and this feeling is really great.

A few minutes later, the professor said, "Boss, this liver cancer is a bit strange, why don't I think it's not?" ”

"Well, it's a little strange, but it's hard to say that it's not liver cancer. Zheng Ren held his cheeks, looked at the film, and said, "I highly suspect that it is an ectopic spleen implant, not liver cancer." ”

"What?" said Professor Rudolf Wagner, surprised, "boss, how did you see it?

As he spoke, the professor clicked on a location on the film where the signal was abnormal.

"Not exactly, it's just a bit of a signal anomaly. Fugui'er, have you noticed, the patient has had an interventional embolization. ”

"Noticed. Professor Rudolf Wagner listened to Zheng Ren talk about embolism, and seemed to remember something, staring at some frames of the film carefully.

Zheng Ren did not continue to explain, for the professor's reading level, he said this by himself, it is enough.

The middle-aged man was puzzled.

Supposedly, shouldn't a liar say that the more serious the disease, the better? But how could this young "doctor" say that it was not liver cancer?

What is planted ectopically?

Is it transferred?

His ears pricked up in confusion, wanting to hear the conversation between Zheng Ren and Professor Rudolf Wagner.

But then the two of them fell silent, didn't say a word, and began to "meet" in front of the film.

A few minutes later, the professor made a fist with his right hand and struck it on the palm of his left hand, making a "pop" sound. This action is full of learning from the professor and Su Yun.

"Boss, I figured it out! It's indeed ectopic spleen planting!" said Professor Rudolf Wagner happily.

"Well, the diagnosis is relatively clear. Especially after an interventional embolization treatment, it has been basically determined. Zheng Rendao.

After speaking, he took off the film, put it in the film bag, and said, "You go to Mr. Yang, and I will write the diagnosis on paper in a while." For this disease, it is enough for Mr. Yang to do an excision operation and postoperative pathological diagnosis. ”

As he spoke, Zheng Ren found a discarded A4 piece of paper, he made a few strokes on the front handwriting, signaled that it was invalid, and then wrote his diagnosis on the back, as well as a surgical recommendation.

The patient's family was stunned.

He had already sketched out in his mind a lot of things that Zheng Ren might say, and he had a contingency plan for each of them.

If it's a liar, what to do, he knows in his heart.

However, this young "crook" went so far as to send himself back to general surgery.

Could it be that I guessed wrong?

The middle-aged man held the paper in his hand, looked carefully at the words on it, and became puzzled.

"Go ahead, I heard from Mr. Yang that your lover had perennial pain in the upper abdomen before, which was caused by spleen planting and backlog of the liver. It's not a big deal, just remove it. Zheng Ren said, taking out his mobile phone.

He first left a note on Professor Yang's mobile phone and then dialed it.

"Mr. Yang, I've finished watching the patient's film. ”

"Uh......"

"Okay, okay. Brother Yang, the film is considered to be ectopic spleen implantation, and liver cancer is not considered. ”

"Yes, yes, you were right. If there is a bed, you can be admitted to the hospital, and you will have an excision operation, pathology...... During the incision, it can be seen that it is spleen tissue. ”

"Oh, okay, I'm here with the patient's family. I'll take it with me......"

"Okay, then I'll wait for you. ”

After speaking, Zheng Ren hung up the phone.

Teacher Yang...... Brother Yang said that he would come down in a while, wait a minute, and save it from encountering. Zheng Ren and the patient's family said.

The patient's family was confused, and the development of things had completely deviated from his expectations.

Soon, Professor Yang wore an isolation gown and a sterile cap and hurried to the interventional department.

"Boss Zheng, I don't think it's like liver cancer. After entering the door, Professor Yang said hurriedly.

It seems that he has just stepped down from power, and he hasn't even had time to change his clothes. It may even be that you took time to run down during the interval between the surgery.

"Ninety percent probability is ectopic spleen planting. Zheng Ren nodded.

Zheng Ren can't and dare not guarantee this kind of thing. If the operation freezes down and is malignant, there is no way to explain it.

Under the premise that there is no gold standard for pathology, Zheng Ren has to doubt the diagnosis of large pig trotters.

"Boss Zheng, your level is really high. Professor Yang praised: "Tell me how you can see it." ”

Zheng Ren felt a little strange, an autologous liver transplant, Professor Yang was like this?

However, he saw that Professor Yang was concentrating on watching the film, and it seemed that he was talking in his heart, so he didn't think much about it, so he smiled.

"You're not involved in intervention, so you don't know much about interventional images. Zheng Ren said: "The patient had an interventional embolization, you see here, in the image of iodine oil deposition after embolization, only embolic necrosis foci exist, and the typical liver cancer foci are not manifested in the image. ”

"Very few liver cancers present this kind of image. Coupled with the patient's medical history, intermittent abdominal pain for many years, and a history of splenectomy 22 years ago, I judged that it was more likely that it was ectopic spleen implantation. ”

Professor Yang watched the film, and Zheng Ren's words solved several of his questions, but the reasons were not very sufficient.

Zheng Ren's words can deny liver cancer with a high probability, but spleen implantation cannot deny it.

"Boss Zheng, if you plant a spleen, ......"

"The 64-slice CT enhancement prior to surgery showed uniform enhancement in the arterial phase and slight enhancement in the venous phase. Angiography showed that branches of the hepatic artery supplied the round blood-rich mass. At this time, liver cancer is suspected, and there is no mistake. Zheng Ren said, picking out another piece from the bag.

"On postoperative reexamination, the arterial phase enhancement of MRI was not obvious, but the metastatic lesions on the abdominal wall showed the opposite characteristics. Zheng Ren said: "Because the blood vessels of the abdominal wall lesion are relatively thin, there is no embolization treatment, which is very similar to the postoperative imaging of splenomegaly. ”

Interventional embolization therapy for splenomegaly and cirrhosis can effectively increase the levels of white blood cells and platelets.

Although Zheng Ren has never done it, interventional surgery is close to its peak, and he knows this "minor surgery" well.

"So, I'm pretty sure the local doctor did a splenic embolization. Zheng Ren smiled.

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