Chapter 2191 Hypoglycemia with Tumor

After seeing the patient, Zheng Ren was taken aback.

The patient system panel is redder than I imagined. All the situations I considered before are wrong. The patient's diagnosis is a very common disease that rarely causes hypoglycemia.

"Boss Zheng, this is my client, Du Liang." Attorney Ge introduced.

"Well, let's come to the emergency room first." Zheng Ren brought Du Liang to the emergency room and began to conduct routine consultations.

Du Liang looked to be in his 50s. He was depressed, but his speech and conversation were fine, which was considered normal.

His emotions are normal, his memory and calculation ability are normal, his orientation is intact, and his insight is normal, all of which are fine.

"Is there anything uncomfortable recently?" Zheng Ren asked.

"Uncomfortable..." Du Liang hesitated for a moment, shook his head, but nodded in the next second, "Doctor, I often lose my mind, and when I wake up, I find that what happened a while ago is blank, and I can't remember it completely." Can't remember what happened."

"And after waking up, my back hurts, and sometimes my whole body hurts, especially my face."

Su Yun almost laughed.

Can it not hurt, just slap yourself on the mouth like that, it will be hell if it doesn't hurt.

"Is there any other discomfort? Is there any weight..." Before Zheng Ren could finish asking, Du Liang's hands began to tremble, as if uncontrollable, he slapped his face.

Zheng Ren really wanted to cut his carotid sinus with one hand, but the case of the deceased just now made him hesitate.

"Is this a disease? Mr. Zhou, measure your fingertip blood sugar." Su Yun said.

"What's your name?" Zheng Ren asked.

"I...I don't know...who am I?" Du Liang said vaguely, "I am Erlang God descending to earth, remember!"

"..."

This can be regarded as slurred speech, Zheng Ren shook his head, watched the patient start to sweat, and immediately said: "After measuring blood sugar, give 50ml, 50% glucose intravenously."

Zhou Litao began to chatter on that side.

Blood sugar is very low, 1.6mmol/L. Less than 3 minutes after the intravenous injection of high glucose, the patient gradually recovered.

Lawyer Ge was not surprised when he saw this situation.

Compared with patients, he is more concerned about how Boss Zheng thinks. If you bring someone to 912 by yourself, even if you have sufficient evidence, you still have to bear a lot of responsibilities.

"Let's think about it, Mr. Zhou, you come with me." Zheng Ren said.

"good."

Several people walked out of the emergency room, and Zhou Litao told a nurse to watch over the patient so that nothing would happen again.

"Boss, let's have a CT scan of the abdomen. I suspect there is something wrong with the pancreas." Su Yun said directly.

This is the organ that Zheng Ren considered most likely to have problems before, but the diagnosis of the system panel is another matter.

"Check the B-ultrasound and CT of the pancreas." Zheng Ren said afterward, "Check a CT scan of the lungs."

Zhou Litao waited for Boss Zheng to continue giving the doctor's order, but the doctor's order was over.

"Boss Zheng, is there anything else?"

"Well, just check these three things." Zheng Ren said.

For admission to the hospital, plain film or CT of the lungs is a routine item. Others think that Boss Zheng just perfected the relevant examinations and didn't pay much attention to it.

After issuing the order and sending the patient for an examination, Zheng Ren sat in Zhou Litao's duty room and waited for Dr. Liang from the CT room to upload the film.

More than 20 minutes later, the CT scan of the pancreas was uploaded.

On the whole, there is no special problem. The pancreatic capsule is complete and there is no growth. Tumor-induced hypoglycemia is more common in islet cell tumors, but the patient's pancreas CT denied this.

Soon, lung CT came back.

A 2×3.5cm space-occupying image in the right lower lung is so dazzling. The ground-glass space-occupying indicates the fact that it is a malignant tumor.

Zheng Ren sighed, the big pig's trotters were still as reliable as ever. Although rare, a definitive diagnosis can be made immediately with a CT scan of the lungs.

"Uh... hypoglycemia with tumor?!" Lin Yuan said in surprise first.

"Well, it was diagnosed as lung cancer and hypoglycemia associated with the tumor. Lin Yuan, ask Lawyer Ge to come over." Zheng Ren said while carefully looking at the patient's lung CT.

"Okay." Lin Yuan ran out quickly, she was afraid that she would miss what Boss Zheng said when she was not around.

Lawyer Ge trotted over.

"Lawyer Ge, consider the patient to be lung cancer." Zheng Ren said directly without looking back.

"Lung cancer?!" Lawyer Ge froze for a moment.

"Well." Zheng Ren said, "The hypoglycemia that induced the patient's nonsense speech and abnormal behavior before was considered to be hypoglycemia associated with tumors. This is a symptom, and it is not important."

"..." Lawyer Ge was stunned.

I just want to win a lawsuit, hypoglycemia is enough for me to win, why is there another hypoglycemia with tumor?

Is the client really sick, and is it lung cancer? But how does lung cancer induce hypoglycemia?

Lung cancer, hypoglycemia, these two words are simply not connected in Lawyer Ge's mind.

Not to mention Lawyer Ge, even Zhou Litao felt strange.

"Boss Zheng, tell me in detail." Lawyer Ge rubbed his hands and said.

"Hypoglycemia associated with tumors is usually the clinical manifestation of the primary disease or hypoglycemia after the diagnosis of the primary disease; clinically, hypoglycemia occurs first and then lung cancer is discovered is extremely rare."

"Uh... but hypoglycemia..." Attorney Ge still didn't understand.

"Hypoglycemia is not an independent disease, but a syndrome of low blood glucose concentration caused by multiple reasons.

Causes of hypoglycemia include: malnutrition hypoglycemia; hepatic hypoglycemia; renal hypoglycemia; autoimmune disease hypoglycemia; reactive hypoglycemia; endocrine disease hypoglycemia; nonislet cell tumor cause hypoglycemia, etc. "Zheng Ren's series of thoughts and various technical terms confused Lawyer Ge.

"Extra-pancreatic tumors accompanied by hypoglycemia are rare, and other types of tumors related to hypoglycemia include mesenchymal tumors, accounting for 64%, 50% of which occur in the abdominal cavity, and hepatomas account for 21%. The situation of this patient It's even rarer, it's lung cancer." Zheng Ren said.

"Why did this happen..." Lawyer Ge still didn't understand.

"Lin Yuan, tell Lawyer Ge why." Su Yun glanced at Lin Yuan and instructed.

"First of all, consider that the patient's symptoms are related to the secretion of insulin-like factor 2 by the tumor. IGF-2 binds to and activates the corresponding receptor, thereby increasing the uptake of glucose by peripheral tissues and reducing the output of hepatic glycogen, resulting in a decrease in glucose in the blood. blood sugar performance."

Su Yun looked at Lin Yuan's way of saying one, two, three, and felt that he was a bit like the boss, and he was too bookish.

"Secondly, the increased glucose utilization of the tumor itself can also cause..." Lin Yuan did not pay attention to Su Yun's expression, but continued to explain the situation.