Chapter 2150

Feng Xuhui was startled by Su Yun's words.

Isn't the diagnosis clear? Although he is not a doctor, Feng Xuhui knows about adrenal crisis. It is certain that the disease is very serious and urgent. But the medical level of the Affiliated Hospital of Medical University is high, which can not be denied. People should have no danger.

But Brother Yun said it was big!

"It seems reasonable to diagnose that renal vein thrombosis leads to adrenal crisis. There is even hematoma caused by bleeding. It's just too coincidental. It's the same as a little boy who suddenly has metastatic right lower abdominal pain to diagnose acute appendicitis. There's nothing to think about."

Feng Xuhui looked at Su Yun blankly. He couldn't say a word about the patient's medical history, symptoms, objective examination, final diagnosis, etc.

"This kind of thing is fine. Once something happens, it's a big deal."

"For example?"

"For example, renal vein thrombosis can be said to be caused by oral contraceptives. We have also done this kind of patient, that is, the student of Medical University who fell." Su Yunbi said.

While explaining his illness to Feng Xuhui, Su Yun is sorting out his ideas.

Feng Xuhui was impressed by the operation. Boss Zheng took out a 12cm large thrombus, which is still fresh in his memory.

"But what a coincidence, I feel uneasy when I look at it." Su Yun smiled.

Brother Yun's judgment is too idealistic. Feng Xuhui didn't believe it. He still felt that adrenal crisis alone was enough.

"The patient had recurrent orthostatic syncope and hyponatremia in the past 7 days. The diagnosis of adrenal crisis was clear. Hypotension was the main cause of syncope." Su Yun nagged casually, "well, you said hyponatremia, and it's not very obvious. This diagnosis doesn't count for the time being."

"Adrenocortical insufficiency leads to adrenal crisis. The common causes of primary adrenocortical insufficiency include adrenal tuberculosis, fungal infection, solid tumor and autoimmune disease."

"I guess the Affiliated Hospital of medical university should also check one by one."

Su Yun nagged here and stopped talking. It's meaningless to go on. It's just a waste of saliva.

For all, wait until you see the limited test results.

Professor Zheng Renhe operated together, but the speed was not very fast. Because the professor is leaving, Zheng Ren is particularly serious, and every problematic step should be corrected repeatedly.

After the operation, Zheng Ren came out of the operating room, and all kinds of data on Lin Yuan's side were also transmitted.

Su Yun dragged Lin Yuan into the group. At the moment of entering the group, Chu Yanran's head flickered.

A series of welcome words made Lin Yuan feel that it was absolutely worth the money to find his old man to do business this time.

Only when you join the group can you be regarded as your own.

She took the time to upload the data, and then watched Gu Xiaoran pick up the patient and brush her hands for the next operation.

"Blood tests are not a big problem." Su Yun and Zheng Ren said.

"Cortisol 0.74 μ G / dl, ACTH 356 pg / ml, normal thyroid function; RAAS in supine position showed plasma renin activity of 3.29 ng / (ML · h), aldosterone & amp; amp; amp; lt; 59 pg/ml； Standing RAAS showed PRA 6.37 ng / (ML · h) and ALD 78.1 pg / ml. "

He picked the one who had a problem and said that Zheng Ren just nodded and seemed to be meditating.

In addition, the results of abdominal enhanced CT were the same as those judged by Zheng Ren and Su Yun - diffuse swelling of bilateral adrenal glands increased, and the sizes of left and right sides were 3.2 cm respectively × 3.4 cm、2.5 cm × 4.9 cm, clear boundary and uneven density.

The CT value is 36 ~ 65hu, there is no clear enhancement on enhanced scanning, and there is a high possibility of adrenal hematoma.

The left renal vein is dilated, and irregular low-density lesions can be seen in the lumen, with a length of about 2.3 cm; A low-density plaque with a length of about 0.8 cm can also be seen in the right renal vein, with a high possibility of thrombosis.

"Boss, do you see the problem?" Seeing that Zheng Ren didn't speak, Su Yun asked.

"In the case, it is said that the patient has pigmentation." Zheng Rendao.

The physical examination of the Affiliated Hospital of Medical University was very detailed, describing the pigmentation of the upper sternal fossa, armpit, waist and abdomen, auricle, palmprint of both hands, dorsal skin of index finger, and pigmentation of lips and oral mucosa.

Scattered herpes can be seen on the left nasal wing. The skin of both mandible is pigmented, scattered papules can be seen, and some surfaces are broken.

These are not described by Feng Xuhui.

"See, tuberculosis, adrenal fungal infection..."

"No consideration." Zheng Ren definitely said.

"Adrenal tumors were also ruled out, which may be autoimmune diseases." Su Yun said with a smile, "you should find Dabai to have a look."

"No, I'll think about it again." Zheng Rendao.

"Everything that can be ruled out is ruled out. I guess it's antiphospholipid syndrome."

"Well, secondary." Zheng Ren added.

"What do you think of treatment?"

Zheng Ren thought for a moment and began to discuss with Su Yun.

This time it was a very professional dialogue. Feng Xuhui couldn't keep up from the beginning.

In the dialogue between Zheng Ren and Su Yun, every noun has to be pondered for a long time. Before he wanted to understand the content of the first sentence, Zheng Zong and Brother Yun had already said the tenth sentence.

Forget it, Feng Xuhui gave up trying to understand it with his brain. Finally, as long as Zheng and Brother Yun gave an answer.

It's interesting to watch them discuss their condition.

President Zheng is still president Zheng of Haicheng. He is honest, simple and honest. He speaks like an old professor in the twilight, quoting scriptures. Brother Yun hasn't changed much. If he doesn't hate president Zheng in three or five sentences, he feels uncomfortable all over.

They talked for nearly half an hour like a quarrel. Xie Yi was used to it. He didn't listen to what they were saying and kept staring at the operation inside.

At the end of an operation, the two are still arguing. It's interesting to hear that they are speculating about possible and unrequited tests according to the existing test results.

This is a non-human operation. Feng Xuhui is a little confused. Is this right?

At the end of the operation, President Zheng explained the operation to Fuguier through the middle interval. And Brother Yun found a pen and paper and began to write.

Facing Su Yun's coquettish operation, Feng Xuhui has no idea what he is doing.

In this way, time flies when Zheng Renhe and Su Yun argue about their condition and see the operation.

After the last operation, Su Yun took a stack of paper and said with a smile, "that's it. The diagnosis is secondary antiphospholipid syndrome."

"Yes."

"Secondary antiphospholipid syndrome, systemic lupus erythematosus, bilateral adrenal vein thrombosis followed by adrenal hematoma; primary adrenocortical insufficiency; adrenal crisis."

Su Yun wrote as he spoke, his black hair floating in front of his forehead, like great pride.

When Su Yun finished writing, Zheng Ren took it over and looked at it, adding a smiling face at the end.

"Boss, they say you're useless."

"Used to it." Zheng Ren smiled and handed more than a dozen A4 papers to Feng Xuhui.