usatvline Chapter 466 - 222: Renal Enlargement Without Kidney Disease, A Doctor’s Parental Heart (Part 2)
Chapter 466 - 222: Renal Enlargement Without Kidney Disease, A Doctor’s Parental Heart (Part 2)
From this, it can be seen that Dr. Tan Shuilin is quite competent in both diagnosis and prescriptions.
However, after three days of treatment, the patient not only showed no significant improvement, but the blood urea nitrogen increased to 22 mmol/l.
Dr. Tan Shuilin realized something was wrong and quickly sought assistance from a senior physician.
The Urology Department indeed has experts, and after further diagnosis and examination of the patient, Director Zhang Zhongsheng from the Urology Department immediately sought help from Nephrology.
Speaking of the Nephrology and Urology Departments, one focuses on medical treatment and the other on surgical, but both deal with kidney issues.
The difference is that Urology specializes in solving kidney stones and ureteral strictures through minimally invasive procedures and surgeries.
Nephrology, on the other hand, excels in medication treatment.
In terms of diagnostic capability, internal medicine is somewhat stronger, naturally.
Because when using medication, you must clearly identify the cause and understand the pathomechanism.
Urology tends to be more straightforward.
In most cases, if stones or tumors are found, they are directly resolved surgically.
The chief physician of Nephrology came to the consultation room and believed that the kidney edema and other changes might just be superficial.
What does that mean?
It means the cause of the kidney enlargement is not the kidney itself; there is another undiagnosed lesion.
Such situations are doctors’ worst nightmare.
The symptoms are obvious, the lesions are also very evident, but the treatment proves ineffective.
The true lesion hides in the shadows, undetected.
Encountering such a case is certainly a difficult one.
In most instances, consultation from other departments is needed.
For instance, the cause of kidney enlargement might also be cardiovascular or liver-related disease. Human organs are independent yet directly or indirectly connected, very closely.
For a simple example, if the heart stops beating, all organs quickly follow in distress.
Once the heart stops, blood circulation ceases, and all organs lose their ’energy’ supply.
Similarly, if the lungs fail, causing respiratory arrest, all body organs suffer greatly, failing altogether.
Because the lungs are crucial for blood oxygen exchange.
Ineffective lung function means no fresh oxygen can enter the bloodstream.
The body halts.
Therefore, every organ in the body is intricate, interrelated like parts of a precision machine, maintaining its operation.
The disease attacks fiercely, advancing rapidly every minute.
Dr. Tan Shuilin is anxious; if this patient deteriorates under his care, will the hospital trust him with consultations in the future?
Moreover, it’s a human life at stake!
He is anxious, and so are the heads of Urology and Director Zhang Zhongsheng.
The department acts as a whole; if serious issues occur, everyone suffers.
To swiftly resolve the situation, the Urology Department head is in a predicament.
Report to the Medical Affairs Department, then escalate to the hospital director to organize internal consultation. It’s an appealing option but very costly.
The best solution is to find a way to resolve it privately.
Transferring the patient out is definitely not an option.
So, the Urology Department head and Director Zhang Zhongsheng started using their connections to seek help from department chiefs within the hospital.
The hidden causes of kidney edema are somewhat limited, yet quite a few.
It’s those major factors.
The heads of Cardiovascular Medicine, Respiratory Medicine, and Gastroenterology became targets for assistance.
Director Mu was invited over.
Director Mu, though quite concerned about face, is very generous.
After consultation, he thought the patient might be suffering from respiratory disease, but wasn’t too certain. A more cunning head physician might simply drop a hint.
But Director Mu took the patient’s data, saying he would discuss it with the entire Respiratory Department.
Though they work in the same department, it’s no small feat to invite chief physicians over!
You say everyone should come to discuss just like that?
Is it possible?
A simple excuse such as attending an academic conference or handling important matters would be enough to decline.
Director Mu had to tackle this tough problem alone.
Not being a patient from Respiratory Medicine, colleagues might secretly criticize him for prying.
Li Jingsheng empathized with Director Mu’s difficulties, sitting silently in the reception hall, analyzing the case alone.
If the true cause isn’t renal failure or acute nephritis, what could it be?
The patient’s symptoms are indicative of renal failure and nephritis!
Urology had invited cardiovascular specialists, and an additional echocardiogram was conducted.
It suggested mild thickening of the ventricular walls and septum.
A subsequent synchronous ECG indicated sinus tachycardia, ST-T normal.
Abdominal ultrasound showed an abdominal mass due to bilateral kidney enlargement; liver, gallbladder, pancreas, and spleen were normal.
A chest X-ray showed faint shadows in the lower left lung.
The diagnostic conclusion leaned towards a lung infection.
This is the main reason why Director Mu took this case.
Currently, the patient is undergoing anti-infection treatment, and continued diuretics, blood pressure reduction, antiemetic, analgesic, and Shen’an injection therapy.
However, the efficacy is poor.
Li Jingsheng repeatedly reviewed the patient data and examination reports he had seen in Director Mu’s office in his mind.