Practicing Medical Skills in a Small Clinic novel Chapter 467

Chapter 467: Chapter 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."

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