The Enhanced Doctor-Chapter 543 forgot to follow Dandan

"Teacher Liu, why do you want to perform pelvic and abdominal CT scans on the patient?" Xu Yino asked curiously after seeing the latest test order Liu Banxia had issued.

"You didn’t think about it when you first came up? I already said the next diagnosis is imminent. Why are you all so lazy? Can’t you use your brains?" Liu Banxia asked. 𝕗𝗿𝕖𝐞𝐰𝗲𝕓𝐧𝕠𝕧𝗲𝐥.𝚌𝐨𝚖

"Teacher Liu, we did use our brains. But the cranial CT, lumbar puncture, and blood tests were all negative. Only the intracranial pressure was slightly high, which might have been caused by the patient’s nervousness," Liu Yiqing said.

"There’s another aspect you forgot to consider," Liu Banxia said.

The interns became serious. They really couldn’t think of what else there could be.

"Did you ever consider a teratoma?" Liu Banxia asked with a smile.

The interns were dumbfounded. They indeed hadn’t thought of this. But how could it be a teratoma?

"Teratomas often occur on the ovaries in females, and we’ve admitted such patients. But for male patients, not having ovaries doesn’t mean teratomas won’t develop," Liu Banxia said with a smile. "For males, the pelvic and abdominal regions are the most likely places for teratomas to grow. Whether or not this is the case, we’ll know once we do a scan."

To be honest, I don’t have a clear idea right now; I just thought of this possibility. If I weren’t worried about the patient’s low intracranial pressure, I would have performed another lumbar puncture, Liu Banxia thought. It’s due to a lack of experience; otherwise, we could have done an NMDA antibody test. Because he’s male, the thought of a teratoma crossed my mind, but I dismissed it as impossible.

"This, if it’s a teratoma... uhm... seems like... mhm," Xu Yino muttered.

"Mhm? Even though I missed the first chance for diagnosis, I thought of it afterwards. Isn’t that still better than you guys?" Liu Banxia said proudly.

"Oh my god, Teacher Liu, can you not be like this? What if the patient doesn’t have a teratoma?" Liu Yiqing asked helplessly.

"If not? If not, then we just continue with the examinations. Anyway, I don’t think he has schizophrenia. His sleepwalking state proves the episodes were intense," Liu Banxia said. "In such an intense situation, if it were schizophrenia, it would definitely affect his regular state as well. But think about it, other than appearing a bit listless, he doesn’t seem to have any other symptoms, right?"

"I don’t think the tension he showed is pathological. Anyone with his symptoms would become nervous, right?"

The interns didn’t say anything. Considering the severity of his sleepwalking today, it’s beyond just being nervous; it was genuine violence and destruction.

"Wow, what a big case, to have all of you involved! This patient must be quite something," Wu Bo said, surprised when he saw their group.

"Scan the pelvis thoroughly. I suspect this patient might have a teratoma," Liu Banxia said with a smile. "But for now, it’s just a guess. We didn’t check for this during today’s lumbar puncture. We can only do a scan first to see; otherwise, I won’t know what to check next."

Wu Bo nodded. "Let’s scan first and see. But if it’s a teratoma, aren’t there any other symptoms?"

Liu Banxia shook his head. "He has no other symptoms besides nightmares and sleepwalking. The only other finding is slightly elevated intracranial pressure, which wasn’t evident on yesterday’s cranial CT."

"Okay, the patient is ready. Let’s start scanning," Wu Bo said, starting the CT machine and beginning the scan.

"Teacher Wu, if it’s really confirmed, our Teacher Liu said he will treat us to chicken drumsticks," Xu Yino chimed in.

Liu Banxia shot her a glare. This was pure retaliation.

"Oh, really? This chicken drumstick isn’t easy to come by. We’re not as lucky as you guys," Wu Bo said. "We can only hide in this small room, watching you all eat chicken drumsticks and pork trotters every day. We’re so envious, we can’t stand it! President Liu, how about it? Can you arrange it for us?"

"Eat, of course, we have to eat. I’ll tell Zhou Qiang later," Liu Banxia said helplessly.

"Wait, something’s not right. This is about something good, isn’t it? You don’t have a new appointment, do you?" Wu Bo asked in surprise.

"Not at all. Today, I’m just going for my marriage registration. These guys started making a fuss about it yesterday; they’re never quiet," Liu Banxia said.

"Haha, I knew it! This is a joyous occasion. This chicken drumstick is a must-eat," Wu Bo said with a laugh.

"They’re all happier than I am. Do you think that once I’m busy with my own affairs, there’ll be no one to manage you?" Liu Banxia turned his head and asked the interns.

"Not at all, we’re happy for Madam," Liu Yiqing said seriously.

"Forget it, forget it. I can’t be bothered to bicker with you. I’ll get my revenge sooner or later," Liu Banxia waved his hand.

Wu Bo found them very amusing; their little team always seemed so lively.

After chatting for a while, the patient’s plain scan images were displayed.

"President Liu, this chicken drumstick isn’t tasting so good anymore. There don’t seem to be any other findings in the pelvis," Wu Bo said with a frown.

Liu Banxia’s eyebrows also furrowed. He was looking carefully at the films; indeed, no abnormalities were revealed.

"President Liu, do we need to do any other tests?" Wu Bo asked.

"Let’s wait a moment. I need to think it over. I thought it could be a sacrococcygeal teratoma," Liu Banxia said.

This matter had to be treated with caution because there’s a limit to the number of examinations a patient can undergo in a single day. Even the most cooperative patient might feel resentful if examined too many times. This patient’s situation was even more special; it also involved his sleep that night.

But now, he really thinks the patient’s reaction is caused by a teratoma. Could it be because the teratoma is small and therefore wasn’t captured by the CT scan? He had encountered patients with teratomas before who had similar situations, only discovered during intraoperative ultrasound. But this patient doesn’t have any other symptoms, so it’s unclear where to check even if he wanted to.

"Teacher Liu, should we go back and talk to the patient to see if there are any symptoms he might have overlooked?" Miao Rui asked.

"We still need to think about it carefully," Liu Banxia said. "If the teratoma contains brain tissue and the immune system mistakes it, attacks on the brain might occur in the early stages. This could potentially cause nightmares and sleepwalking, right?"

The interns nodded in agreement.

That was a possibility, but the patient hadn’t been diagnosed yet. The only way would be to wait until tomorrow, perform another lumbar puncture, and test for NMDA antibodies.

"Teacher Liu, should we perform a serum NMDA antibody test?" Xu Yino suggested.

Liu Banxia shook his head again. "I thought about that initially, but the serum NMDA antibody test often shows false positives and would need to be compared with a cerebrospinal fluid test."

"Teratomas in females commonly occur in the ovaries and are sometimes small and hard to discover. These are often immature tissues and frequently malignant."

"And in males? They commonly occur in the pelvic area. We just did a CT scan and found nothing. Think about it, did we forget anything?"

"We..."

SMACK!

Liu Banxia slapped his forehead. "How could I be so stupid?"

Hearing his self-deprecation, the others were taken aback. There’s something off about Teacher Liu today. First, he insisted the patient had a teratoma, and now he was calling himself stupid. Could this be wedding jitters? That didn’t seem right. Teacher Liu and Madam were very affectionate and often flaunted their love in front of everyone.

"Did any of you pay attention to the patient’s testicles?" Liu Banxia suddenly asked.

The interns collectively rolled their eyes, then froze.

Yeah, why didn’t they pay attention to the patient’s testicles? Female teratomas commonly occur in the ovaries, and male teratomas commonly occur in the pelvic area. For males, shouldn’t the primary site be the testicles?

"Let’s get the patient out here and perform an ultrasound. If nothing shows up then, we’ll have to wait until tomorrow to do another lumbar puncture," Liu Banxia said.

The interns scrambled out. They had to be present for this examination.

"President Liu, do you really think it’s a teratoma?" Wu Bo asked curiously.

Liu Banxia nodded. "I just have this feeling, a conviction that it is. From when the patient was admitted last night until now, his appearance during an episode was terrifying."

"I still haven’t let the patient eat. My thinking was that if a teratoma was detected, we’d proceed with surgery immediately. He’s struggled with sleep for over a month; last night was the first time he slept soundly for a good portion of the night."

Wu Bo nodded. "Hurry up with the examination. Otherwise, your mind will be a mess when you go for your marriage registration today. Have you set a wedding date?"

Liu Banxia shook his head with a bitter smile. "How can I set a date with my current workload? I’ll have to wait until I step down as chief resident. I’ll follow them over to take a look first. The chicken drumsticks for lunch must still be there."

"Haha, I won’t be polite then! I’ll definitely eat those chicken drumsticks," Wu Bo laughed.

When they got outside, Liu Banxia headed straight for the ultrasound room.

The ultrasound quickly revealed a mixed cystic and solid mass on the left testicle. The image indicated that the solid component was larger than the cystic component.

Xu Yanli, the ultrasound doctor, nudged Liu Banxia. Liu Banxia nodded, indicating he had seen it.

Ding! "Dream-Loving Patient" task completed.

Rewards: 200 Experience Points, 100 Diagnostic Skill Proficiency Points, 2 Glory Points.

The patient was diagnosed, and the task was completed, but Liu Banxia couldn’t feel happy.

Based on the patient’s current examination results, this might be an immature teratoma, as the solid component is larger than the cystic component.

"What about the surrounding lymph nodes?" Liu Banxia asked.

"Currently, there don’t seem to be any changes," Xu Yanli, the ultrasound doctor, replied.

This was probably the only piece of good news so far. If it turned out to be malignant and had already metastasized, it would be very difficult to treat.