The Enhanced Doctor-Chapter 571: Is a tumor or inflammation?

The establishment of the Obstetrics and Gynecology department had truly given the emergency center a shot in the arm.

One shouldn’t assume that just because they’re a doctor, they dare to handle anything. Performing surgery on a pregnant woman requires extreme caution.

"Now we’re set, right? As soon as a pregnant patient comes in, we’re ready to call Doctor Huang," Liu Banxia said with a smile.

"Ah... I’m just as thrilled as you are," Shi Lei said emotionally.

"When will the director’s surgery be done today?" Liu Banxia asked.

"If you ask me, who should I ask? It depends on the circumstances of the surgery. Although the patient was transferred here, the adhesions are said to be severe," Shi Lei replied.

"No lunch for us, then. I was planning to gather everyone for a spontaneous lunch to welcome the three doctors from Obstetrics and Gynecology," Liu Banxia said.

"Haha, you can do it yourself. Considering you’re our rightful steward in the emergency center, it should be no problem," Wei Yuan chimed in.

"You’re terrible, with such wicked intentions. Wouldn’t I have to pay out of my own pocket then? I’m not made of money, you know!" Liu Banxia muttered.

"By the way, I’m off the day after tomorrow. Can you guys cover for me a bit more? My phone not ringing would be ideal, alright?"

Shi Lei laughed and nodded. "That should be no problem. But why are you asking so early?"

"I have no choice but to plan ahead. I miss my wife," Liu Banxia replied plaintively.

Everyone burst into laughter, seemingly forgetting that this young fellow was a newlywed.

It could be considered his bad luck. Being so highly regarded by the Chief Director and the director, he had no choice but to take on more responsibilities and endure busier schedules.

Otherwise, why would they call him the big steward?

It was because although he wasn’t officially named deputy director, he effectively performed the duties of one. He handled everything flawlessly, from major and minor matters in the emergency center to communication with the various departments in the inpatient division.

And it was no small job. The fact that he could put Shi Lei and the others at ease, and reassure Zhou Shuwen, was a remarkable achievement in itself.

"President Liu, could you come here for a second?" At this moment, Wang Huan came out of the internal medicine examination room and beckoned to him.

Liu Banxia quickly went over; a consultation was needed.

When he entered the consultation room, he saw a female patient in her thirties. With just a glance, he noticed severe jaundice from her skin color and eyes.

"She occasionally has upper abdominal pain and noticed that her skin was yellowish, so she came to the hospital. An ultrasound showed gallstones, and stones in the common bile duct as well. But during the ultrasound, a mass was observed at the head of the pancreas, so she had an enhanced CT. Take a look at the images," Wang Huan explained.

Liu Banxia sighed internally; this was a consultation he didn’t want to get involved in.

Although Wang Huan was just introducing the situation, it was already apparent. Looking at the patient’s CT scan, with the active contrast agent at the pancreatic head, there was little room for doubt.

Malignant tumors, or tumors located in vascular-rich sites, typically grow swiftly and have many blood vessels. Therefore, during an enhanced CT, the contrast agent in that area will be highly active.

Liu Banxia had a certain apprehension about pancreatic cancer because it was a truly difficult disease to contend with. Looking at the patient’s CT scan, the mass was obvious. It could very likely be stage two.

"What do you think?" Wang Huan asked.

Liu Banxia frowned. "What about the blood test results?"

"They haven’t come out yet. We didn’t think it would be this serious, so we didn’t request for the tests to be expedited, but they should be out soon," Wang Huan replied.

"Judging from the current images, there is a certain surgical indication, but the prognosis is not very clear," Liu Banxia said after a moment of thought.

"Doctor, I just searched online. Is pancreatic cancer basically incurable?" the patient asked.

Liu Banxia hesitated before nodding. "Indeed, that’s the case. All we can do is try to control it. Actually, it’s similar to all other cancers, where the five-year survival rate is an important indicator."

"From the current images, it’s at most stage two and hasn’t invaded nearby blood vessels. However, we can only determine whether there are metastases to the nearby lymph nodes after opening the abdomen."

Facing pancreatic cancer, all he could do was tell the patient the truth. This wasn’t a condition that could be sugarcoated.

The patient’s expression instantly turned gloomy. Her suspicions had been confirmed by Liu Banxia.

"Under these circumstances, I can’t give too much advice right now," Liu Banxia said. "After all, there is still some chance. If it has invaded surrounding tissues and blood vessels, then I wouldn’t say much more. Wasting money and enduring suffering... it would be better to enjoy life."

"Stages one and two are operable. With active cooperation in follow-up treatment, although there will be some hardship involved, there is still a chance."

"Doctor, isn’t it true that the chance is slim, and it will cost a lot of money?" the patient asked with a bitter smile.

Liu Banxia nodded. "Postoperative chemotherapy is required, which will cause some suffering. But if you respond well to the chemotherapy drugs, then there is a good chance."

"Last summer, I diagnosed a patient who was in stage one. His current health condition is quite good. Let’s wait for the blood test results to see how your liver function is."

"If possible, I personally recommend arranging surgery as soon as possible. The progression of pancreatic cancer is very fast. A few days’ delay may change the condition."

"Doctor, could... could I have a child first?" the patient asked.

"This... I personally do not recommend it," said Liu Banxia.

At this point, the patient’s phone rang. She glanced at it, hesitated for a while before answering, "I’m in Internal Medicine Consultation Room 1 right now. You can come over."

Within less than two minutes, a man walked in from outside.

"This is my husband," said the patient.

"Is there a problem with her liver?" asked the patient’s husband.

The patient smiled and shook her head. "The liver is fine. It’s the gallbladder. There are stones in the gallbladder."

Liu Banxia sighed inwardly. The patient still hadn’t decided to tell her husband the whole truth. But this kind of thing couldn’t be hidden, nor was it something that should be.

The patient’s husband, on the other hand, let out a long sigh of relief. "That’s good. We can just deal with the stones, right? Can’t they be broken up?"

Upon finishing his question, the patient’s husband looked at Liu Banxia and Wang Huan.

"Gallstones and common bile duct stones cannot be treated with extracorporeal lithotripsy," Liu Banxia replied. "She has quite a few stones. The only way to handle them is through surgical intervention. We need to remove the gallbladder."

"What about medication? Can’t stones be expelled by taking medication?" the patient’s husband asked again.

"That applies more to kidney stones," Liu Banxia explained. "Gallstones, when not severe, can be managed conservatively. However, considering her severe jaundice, surgical intervention is the only option."

The patient’s husband frowned. "Well, that’s alright, let’s go for the surgery. She’ll have to watch her diet afterward, right? She can’t eat foods high in fat, correct?"

Liu Banxia nodded. "After the removal of the gallbladder, she would indeed be missing an organ. That’s definitely something to be mindful of."

As of now, all Liu Banxia could do was speak evasively, as it involved patient confidentiality. Unless explicitly permitted by the patient, he had to cooperate with her wishes.

However, he could understand the patient’s feelings. It’s a process to accept such devastating news.

But regardless of her choice, she would have to tell him eventually. Whether she opted for surgery or not, as her physical condition deteriorated, she would have to disclose the truth.

"Why did you rush over? It’s nothing serious. You should go back first. You can take leave when it’s time for the surgery," the patient said with a smile.

"It’s alright, I’ve already spoken to our manager," replied the husband.

"You’ll need to take care of me at the hospital for several days. It might require an open abdominal surgery because I have too many stones, and they’re not easy to treat. So you should head off first," she added.

The patient’s husband frowned and turned to look at Liu Banxia. Liu Banxia didn’t dare meet his gaze and turned his head to the side, pretending not to see.

"Tell me, is there something wrong with her liver?" the patient’s husband queried.

"The liver is fine; it’s just the gallbladder issue. If there were something wrong with the liver, wouldn’t I have called you already?" the patient responded.

"Then why do you keep trying to shoo me away? Doctor, you tell me," the patient’s husband directed his gaze at Wang Huan.

"Well... actually, the examination isn’t complete yet. We’re still waiting for the results from the blood tests," Wang Huan reluctantly replied.

This kind of situation was truly difficult to handle. If the patient stubbornly refused to say anything, they, the doctors, would be in the most difficult position.

The patient’s husband remained quiet, just fixing his gaze on the patient.

Clearly, the atmosphere wasn’t right; she must be severely ill. Otherwise, they wouldn’t be speaking so evasively.

The patient sighed and finally explained her test results, though she still chose to hold back some information, stating it wasn’t too serious and they would decide on the treatment once the blood test results were out.

Even so, her husband started wiping away his tears.

For an ordinary family, any kind of cancer diagnosis would be hard to bear.

At this point, a nurse came in from outside, holding the patient’s blood test report.

The liver transaminases and bilirubin levels were significantly elevated, indicating that the patient’s liver function had also been damaged to some extent.

This was considered normal, as all parts of the body work in coordination.

Given the numerous gallstones in her gallbladder and common bile duct, bile secretion was definitely affected. Additionally, the enlarged pancreatic head and dilated common bile duct were exerting some pressure on her liver.

However, when Liu Banxia flipped to the last page of the report, he was stunned. His eyebrows furrowed deeply. The patient’s tumor marker, CA19-9 antigen, was surprisingly negative.

What a joke!

The patient’s pancreatic head was so enlarged, yet no tumor markers were detected.

DING! Assignment released: Is it a tumor or inflammation?

Open assignment: Despite the clear indications from the patient’s ultrasound and CT results, the screening for the patient’s tumor markers was negative. The host needs to diagnose further. The reward will be issued based on the diagnostic results.

Liu Banxia handed the last page of the report to Wang Huan, tapping it with his finger. Wang Huan also frowned upon reading it. What was going on here?