lpffa Chapter 467 - 222: Renal Enlargement Without Renal Disease—A Doctor’s Parental Heart (3)
Chapter 467 - 222: Renal Enlargement Without Renal Disease—A Doctor’s Parental Heart (3)
The urology department now believes that the patient has polycystic kidney disease, but actually, from the ultrasound results, the possibility of polycystic kidney disease is extremely low.
Polycystic kidney disease is generally mostly congenital.
Severe polycystic kidney disease, according to literature descriptions, can weigh more than 2.6kg.
Li Jingsheng thinks the possibility of polycystic kidney disease is very small. If the patient truly had this disease, it should have erupted long ago.
Could it be idiopathic retroperitoneal fibrosis?
He can’t help but think of a disease that fits the symptoms quite well.
This disease is also known as obstructive periureteritis, related to connective tissue abnormalities, and sometimes has certain correlations with infections.
Considering the patient’s chest X-ray showed there is a lung infection, Li Jingsheng suspects this disease more.
However, the patient’s abdominal mass has been confirmed to be both kidneys, with no internal water retention, and serum proteins and immunoglobulins were also normal, so the possibility of this disease is also very small.
Since the above two diseases are ruled out, the only thing that can be thought of is probably a primary renal tumor.
This disease will present three combined symptoms: lower back pain, abdominal mass, and hematuria.
Generally, it is most common in men over forty.
To diagnose, the patient’s consent must be obtained to perform a kidney biopsy.
Li Jingsheng decides to think from another angle, as the patient reports pain in the lower right limb, which is actually a very good breakthrough point.
Is it sciatic nerve pain, or is it due to the pressure from a lumbar tumor?
He believes the possibility of tumor pressure is greater.
If possible, it’s best to check a pelvis X-ray and a lumbar spine front and lateral X-ray.
This way, it’s possible to clarify if there is any pelvic lesion.
Li Jingsheng felt a bit thirsty and drank two large glasses of plain water, just right to sober up.
As for the claim that strong tea helps sober up, there is no scientific basis at all.
On the contrary, it can possibly aggravate the burden on the liver and kidneys.
He leaned back against the chair, one hand supporting his side face, still desperately pondering this female patient with bilateral kidney enlargement and lung infection.
Half asleep, he just sat there and fell asleep.
After working all day at the hospital, then returning to organize a dinner to entertain colleagues from Old Street of South City, he really was tired.
Having had a few drinks, he was even more drowsy.
After a while, he was awakened by the ringing of his mobile phone.
Opening his eyes for a look, he was still sitting in the reception hall, with the lights turned on, and it was pitch black outside.
Glancing at the clock, it was eleven forty-two at night.
Almost midnight, who was calling him?
Fumbling for his phone, it was surprisingly an unfamiliar number.
"Hello, may I ask who you are looking for?"
"Dr. Li, it’s me, I’m Qin Fei. Didn’t you ask me to keep an eye on the patient in bed 53 tonight? I just measured his temperature, and indeed he’s got a fever! 37.4 degrees, a low-grade fever."
Dr. Qin should be quite depressed.
Li Jingsheng and he are colleagues in the same department, yet he didn’t save his phone number.
Pity him for still keeping in mind what Li Jingsheng instructed.
It’s heart-wrenching.
"Oh oh, so it’s Doctor Qin! What did you say? That male patient with lower body paralysis really has a nighttime low-grade fever?"
"Yes! I’ve measured three times, can confirm."
Qin Fei feared Li Jingsheng would doubt his competence, so he emphasized the measurement process.
"You’ve worked hard!"
Li Jingsheng was quite excited to hear this news.
"We’re all colleagues in the same department, Dr. Li saying this is a bit too distant! I know my diagnostic skills can’t compare with yours, this difficult case is a key priority for our department, and I hope Dr. Li will pay extra attention."
Qin Fei’s change is quite significant!
Has Director Hua pressured him? Then has his awareness improved?
Ending the call, Li Jingsheng rubbed his temples. Tomorrow he has to consult in the clinic, Second Hospital has two difficult cases, and neither has been resolved.
He went to the bathroom, and after urinating, his bladder felt much more comfortable, his whole body relaxed.
He washed his face with cold water.
He decided to go to the inpatient ward at Second Hospital to see the patient who had spinal canal repair surgery.
Even though the lumbar spinal canal has already healed, why is the patient still paralyzed in the lower body? Nerve checks didn’t find obvious abnormalities, where could the problem be?
The cause of lower limb pain for the female patient with bilateral kidney enlargement has not been found either.
There’s also the possibility of a nerve issue.
Going to the hospital for a look, giving them a thorough examination might lead to new discoveries.
Li Jingsheng is interested in researching difficult cases but has not reached the level of ’madness.’
He’s willing to take a cab now, because thinking if he can find the cause, not only can he help the patients eliminate pain and restore health, it might even save two families.
Especially that male patient, his girlfriend rejected him due to his paralysis and left.
Under dual pressure, the likelihood of despairingly contemplating suicide is very high.
Taking a cab in the middle of the night is really difficult, Li Jingsheng waited for a long time on the big street outside Old Street before finally flagging down a taxi.
There were two young female passengers inside, wearing smoky makeup and somewhat daring clothing.
Seeing the taxi driver stop in front of Li Jingsheng, they seemed a bit displeased.
Mainly because in the dead of night, they worry about encountering wrongdoers.
Actually dressed like this and not going home at such a late hour, they probably are not strictly speaking reputable women.
"Driver, is it okay to go to Second Hospital?"
"Hop in! Just on the way, giving you a ride. No need for the meter, eight bucks okay?"
"No problem! Thank you!"
Li Jingsheng got into the car.
"Then, ladies, it’ll cost you a few less bucks later. It’s really hard to get a cab so late, let this guy carpool with us."
"Alright then!"
One of the young women agreed.
Listening to this voice, it seems particularly young. No way do they seem like aunties over thirty.
Dressed like this, nowadays young girls really know how to have fun.
Li Jingsheng is seated in the front passenger seat.
"Going to the hospital so late, are you feeling unwell?"
The driver asked him.
"I’m going to see a patient."
Li Jingsheng replied casually.
"Is it a friend or relative of yours who got suddenly ill and was rushed to the hospital?"
"No, I’m a doctor there, a patient has a fever, I’m going over to take a look."
Li Jingsheng’s forehead had black lines straight up.
This driver is quite kind, just talks too much.
"Really or not? Normally, you doctors are all aloof and don’t care whether patients live or die. Ahem... I’m not talking about you, I’m just saying about some doctors."
"Focus on driving!"
Li Jingsheng obviously didn’t want to talk much with this driver.
As his skills and status continue to improve, mainly due to his income rapidly increasing, his mentality has significantly changed in social interactions.
Can’t quite describe it, just that there’s a bit more composure and calm confidence.
With balance in the account, daily income, all this adding more confidence and courage to survive in this society.