Chapter 980: Chapter 982: Could it be… I’m good at making phone calls? (Large Chapter) Chapter 980: Chapter 982: Could it be… I’m good at making phone calls? (Large Chapter) The young couple who brought the elderly man were not locals of the capital.
The old man, nad Zhao Kai, was 77 years old this year. His spouse had passed away seven or eight years ago, and he lived alone.
He had two sons and two daughters, all residing in the capital.
In his youth, Zhao Kai was quite capable, having opened a factory in Langfang and earned a considerable sum of money.
He had also managed to acquire a few sets of property in the capital during favorable tis.
Back then, the houses were small in size. A family of six couldn’t possibly fit, and large flats weren’t popular at the ti, so the old man bought an apartnt in a complex—one floor, two rooms—which undoubtedly made things much more convenient.
To say he was wealthy would be an overstatent.
Later, when his children married, he gave the houses to them and kept the old one for himself.
Firstly because it was an old neighborhood which his son and daughter-in-law looked down upon, and secondly, he was aware that as his children grew up, they didn’t like staying with him.
After his spouse passed away, the old man tidied up a room and rented it out, otherwise the place felt too deserted and was quite botherso.
But this rental brought trouble; first, the eldest son ca back crying, explaining how his grandson wanted to study abroad, and the family had a mortgage on a new house to pay, causing financial strain.
Moved by compassion, and thinking that he’d eventually leave everything to them anyway, Zhao Kai had the tenant transfer the rent directly to his son.
When the younger son found out, he too ca around, followed by the two daughters.
A dispute erupted, and the old man reluctantly decided to alternate the rent between his two sons annually.
Once money was involved, it beca a big issue.
A couple of years prior, as Zhao Kai lived alone without much zest for life, an old friend suggested introducing him to a companion.
He ntioned that one shouldn’t be too lonely in old age as it made one prone to passing away sooner.
After so discussion, a few old friends prepared to introduce him to an elderly lady.
Zhao Kai initially resisted the idea, feeling it was akin to remarrying.
However, after getting to know her, he found it surprisingly pleasant, and the two, not bothering with formal marriage, started living together quietly.
But once their children found out, they ca back to confront Zhao Kai.
“Dad, she’s just eyeing our family’s property. Our neighborhood is pri real estate; a relocation could fetch millions per square ter!”
“Right, you can’t get married. That old lady has three sons, and rumor has it one is still unmarried. What if they start clinging to our family, then what?”
“Exactly! Dad, you can’t be muddled!”
“And imagine how sad my mom would be if she knew!”
Amidst all the arguing and fussing, they managed to drive the old lady, who was over seventy, to tears; she left in the middle of the night.
Infuriated, Zhao Kai scolded everyone, “You bastards, are you trying to force into an early grave? Wouldn’t it be perfect if I died right when the property was up for relocation, and you could get the compensation money, huh?”
This ordeal even made the old man seriously ill.
However, after this incident, Zhao Kai distanced himself from his children.
Or rather, his children took the opportunity to distance themselves from him.
Nevertheless, Zhao Kai beca wiser from then on. He received both comrcial and corporate pensions, a significant sum each month.
He didn’t have much use for it alone, but now he firmly held onto his money.
After all, “Old resentnts endure,” as the old saying goes—there was wisdom in those words.
Now, Zhao Kai was still sprightly and active, but watching his children, it seed they feared becoming entangled and unable to get free.
…
…
The police contacted the family, but they didn’t show up promptly.
However, the results of the old man’s dical tests ca out.
Chen Cang, who took Zhao Kai for an abdominal CT scan, had diagnosed him with acute pancreatitis as soon as the results ca in.
The abdominal CT scan results showed: a well-demarcated tumor in the second part of the duodenum, enlarged pancreas body, and slightly dilated main pancreatic duct.
Chen Cang and Li Yue were both puzzled by these results!
Pancreatitis was certain, but… what about this tumor?
A tumor?
It didn’t seem like it!
Li Yue frowned, looking at the radiologist, “What’s this? A tumor?”
The radiologist frowned, “Doesn’t really seem like it, if it were a tumor… would it be this large?”
After seeing this, Chen Cang suddenly said, “Dr. Wang, scan a few more layers above this area!”
Upon hearing this, the radiologist imdiately nodded!
Before long, the results ca out!
There seed to be morphological abnormalities in the stomach as well, but it wasn’t entirely clear what was going on.
Neither CT nor MRI is omnipotent; they also have their limitations.
Chen Cang stared at the dozen or so images on the computer and fell into deep thought!
At that mont, Chen Cang suddenly beca excited because he discovered sothing miraculous!
The perfect level of abdominal imaging a four-dinsional human model created a miraculous reaction!
Chen Cang could actually reconstruct the situation inside the patient’s abdominal cavity by combining the structures of each layer in the images.
At that mont!
Chen Cang almost jumped up in excitent.
He carefully watched the four-dinsional image, and then, using the feedback from each CT image, continuously remodeled it, forming a structure reconstruction of the upper abdon!
At this ti!
Ti ticked away.
Chen Cang stared at the oddly-shaped gastrointestinal tract and suddenly thought of a special disease!
An intussusception of the duodenum and stomach!
This kind of gastrointestinal intussusception is very rare.
At this mont, Li Yue looked at Chen Cang with a delighted expression and couldn’t help asking, “Chen, what do you see?”
Chen Cang nodded, “Yes, I have a hypothesis, but the patient needs a gastroscopy to confirm it.”
Hearing Chen Cang’s words, the two turned and stared at him, “Oh? What’s the situation?”
Chen Cang directly pointed at several images on the computer and said, “Look at these five images together.”
“This might be an atypical presentation of a gastric-duodenal intussusception, also known as Bouveret’s syndro, a rare disease!
Look here! It is actually caused by a pedunculated gastric wall lesion prolapsing into the duodenum.”
Hearing about this rare disease, everyone was stunned.
The radiologist had heard of this disease, but didn’t know much about it.
However, Li Yue was different; as an experienced surgeon, he frowned and asked, “But I know of Bouveret’s syndro, why would it compress the ampulla of Vater? And, what’s with this protrusion?”
Hearing Li Yue’s question, Chen Cang took a deep breath, his eyes sharp, and said, “If I’m not mistaken… it could be a tumor. Look closely, this entity is different from the signals in the tail; I suspect this is a tumor in the tail.”
“And this is also the main culprit causing many of the patient’s issues!”
“Gastric cancer causing gastric-duodenal intussusception tends to occur in the distal part of the stomach, mainly happening in the pylorus, with fewer occurrences in the stomach body, fundus, and anastomoses.
But the intussusception’s downward traction on the duodenal wall might twist and obstruct the ampulla of Vater.
The head of the intussusception reaches the second part of the duodenum, thus forming a unique shape for the patient!
This leads to the compression of the ampulla of Vater and is associated with acute pancreatitis and biliary obstruction.”
Chen Cang’s words left Li Yue and the radiologist sowhat dazed!
In reality, every radiologist is a “modeler.”
They combine serial CT images to create a ntal map of anatomical structure.
This not only requires considerable image reading ability!
It also demands an excellent foundation in anatomy, spatial awareness, and more…
Quickly, after reviewing the images back and forth twice, Li Yue’s frown relaxed, and if all was as Chen Cang had said, everything made sense!
As an ergency surgeon, his diagnostic ability was indeed strong!
There’s a saying within the dical community,
What’s the ultimate act of prowess for a surgeon?
The answer is: to beco a physician!
What does that an?
Physicians’ ability to diagnose and treat is generally stronger than that of surgeons, as specialization matters.
However, at that mont, Chen Cang’s diagnostic ability was on par with that of a physician.
Of course, Chen’s ability to read imaging naturally surpassed that of “imaging doctors!”
At that point, the radiologist couldn’t help but say, “Doctor Chen, that’s really impressive!”
“Better than , who specializes in imaging! Do you have any tips?”
Chen Cang cleared his throat, “Nothing but practice.”
…
…
Having shown off, Chen Cang quickly took Li Yue to the CT machine to retrieve the patient.
After all, the elder had no family mbers to assist, so they had to do it themselves.
Alone, the radiologist stayed back, feeling like he had heard that phrase before but couldn’t recall where.
After moving the elder out, Zhao Kai seed to be in less pain and couldn’t help but ask, “Doctor, what’s wrong with ?”
Pushing the bed, Chen said, “Don’t worry, it’s acute pancreatitis and biliary obstruction, that’s why your stomach hurts and you feel nauseous and vomit, don’t worry.”
Hearing Chen’s words, instead of relaxing, Zhao Kai sighed.
Slowly he said, “Ah… I am aware of my condition. I’ve been eating less for over a year now; I’ve lost twenty to thirty pounds in this past year.”
“Doctor, don’t deceive . My wife was a doctor, and I know quite a bit. I feel I might have a serious illness.”
“Truly, if it’s my ti, I am not afraid. It’s rare for people to reach seventy, and at my age I have enjoyed my blessings and seen everything I needed to.”
Chen listened to the elder’s slow speech without interrupting.
The elder spoke clearly and appeared well-educated.
However, such a sorrowful sentint was undesirable, so Chen tactfully changed the subject, “Old man, you must be quite cultured, aren’t you? What did you do?”
Initially sighing, the old man paused upon hearing Chen’s question, caught off guard, then collected himself and said, “In my life, I’ve lived through quite a bit. I saw Japan surrender, knew of Chiang Kai-shek fleeing to Taiwan, and even witnessed the founding of the People’s Republic of China… I was thrilled then!”
“Following the Chairman, having enough food, and then… later during the era of reform and opening up, I was bold and caught the wind, setting up an orange soda factory in Langfang. Back then, our country had quite a few good sodas like Beibingyang, Shanhaiguan… and the formulas were shared, no patents involved. Around the nineties, Pepsi and Coca-Cola bought us out…”
A 77-year-old man, born in 1943, truly a witness to the New China.
Listening to the old man, Chen Cang and Li Yue wondered about the upcoming issue of signing the consent form.
It’s risky for a 77-year-old to undergo a gastroscopy, and with no family mbers present, who would sign?
Perhaps the elder himself could?
Legally speaking, signature by the person themselves or imdiate family mbers would suffice!
But, for patients like this elderly man, even if he signed, if problems arose, family mbers could still create trouble.
In other words, sotis the patient actually only has the right to disagree with the surgery, but not the right to decide on the surgery.
The elderly patient now has acute pancreatitis, as well as acute biliary obstruction, plus duodenal intussusception, possibly caused by a tumor.
Perhaps many people don’t understand why the patient could develop acute pancreatitis.
This actually involves an anatomical issue!
The common bile duct and pancreatic duct both open into the Ampulla of Vater in 80% of the population, then enter the duodenum!
However, at this ti, there is high pressure inside the duodenal lun, which causes the duodenal fluid to reflux into the pancreatic duct, activating pancreatic enzys and causing acute pancreatitis.
Thus, this leads to acute biliary obstruction and acute pancreatitis.
It’s actually similar to an autoimmune disease.
One’s own immune cells kill their own tissues and cells.
And this pancreatitis, it’s essentially the body’s digestive fluids digesting its own pancreas, leading to disease.
In fact, the situation in the human body is really complex.
After returning, Nurse Yang Jie imdiately said, “We contacted the police station, but… they still can’t co now, what should we do?”
This statent made Li Yue and Chen Cang quite anxious!
When will they co if not now?
At this mont, the test results also ca out.
Chen Cang took a look, “White blood cell count 17200/μL; aspartate aminotransferase level 183U/L; alanine aminotransferase level 81U/L; bilirubin level 3.60mg/dL; amylase level 3686 U/L.”
Basically, the condition could be clearly diagnosed.
But… the most important situation, stomach cancer causing acute pancreatitis, biliary obstruction, and stomach duodenal intussusception.
It was essential to have a conversation with the family.
Chen Cang couldn’t help himself, “What’s the phone number? I’ll make the call!”
Yang Jie reported the son’s phone number.
Chen Cang directly made the call.
After the call connected, Chen Cang said directly, “Hello, you are Mr. Zhao Kai’s son, Zhao Zhiteng, aren’t you? I need to discuss sothing with you, your father’s condition is very dangerous, a tumor is likely present, we now need to complete a gastroscopy examination, perform a biopsy, you all need to co down here!”
Upon hearing about stomach cancer, the man was montarily stunned, “Okay, doctor, I’ll be right there!”
Chen Cang was montarily stunned!
Was he so easily agreeable?
He had been preparing for a long explanation, but to his surprise… it was that simple?
Afterward, Chen Cang made three or four more phone calls, and having inford everyone that the elderly man had stomach cancer, they all ca!
Chen Cang was stunned!
Could it be… that I was also ‘on a roll’ while making calls?
After hanging up, Chen Cang shrugged his shoulders, “Looks like they all want to co!”
Even those around him were stunned.
Even Yang Jie was lost for words, “I put it even better than you, but why didn’t they co?”
At this mont, a young tenant said, “Because the doctor ntioned the old man has cancer, so…”
Suddenly, everyone was stunned!
That statent was really profound…
…
ps: Two in one, seeking votes~
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