Zhou Congwen sent the patient to the ICU, and at this time, Mr. Huang had already boarded a black Audi and headed straight for the coach's mansion.

In the car, Mr. Huang closed his eyes, looking old, and the scene of being so energetic just now on the operating table disappeared.

It seemed as if all the energy on Mr. Huang was taken away, leaving only one body, and one body buried in his neck.

When he arrived at the coach's mansion, a director and a middle-aged man in Zhongshan suit stood at the door to greet Mr. Huang.

"Old Huang, you are here." The doctor saw that Old Huang got out of the car and hurriedly came forward.

"Oh~~~" Old Huang's eyelids didn't fully lift up, as if he had grown old in his bones, without any extra energy, and even the ending sound of his speech was extremely long, with a smell of dust from history.

The middle-aged man frowned and looked at Mr. Huang, his eyes full of distrust.

"Old Huang." The director sighed, "This consultation had nothing to do with thoracic surgery, and I didn't want to bother you, but isn't this difficult thing..."

"Tell me about the situation." Mr. Huang said softly.

At this time, Mr. Huang was like an ordinary old man, old and weak, bowing his hands and walking tremblingly into the commander's mansion.

The doctor and Huang Lao reported on the patient's condition.

The patient was 88 years old and had sudden palpitations and had episodic confusion.

After admission, blood pressure was measured at 225/114 mmHg; creatinine was 77.1μmol/L, blood sugar was 2.5 mmol/L, insulin was 19.26μIU/mL, C-peptide 3.98 ng/mL.

The hunger test was negative.

Because blood sugar deviates from normal values, symptomatic treatments such as blood pressure reduction and diet are given, and then they still recur. The blood sugar fluctuation range during the onset is 2.1 to 2.7 mmol/L.

At that time, the health care group consulted and considered hypoglycemia caused by endogenous hyperinsulinemia.

There was no improvement after symptomatic treatment. The Ga-exendin-4 PET/CT performed this morning showed that a nodule with abnormally increased radio uptake was seen at the pancreatic body-tail junction, with a size of about 1.1 cm × 1.3 cm, which was consistent with the overexpression of glucagon-like peptide-1 receptors. Diffusion radio uptake was seen in the remaining pancreatic tissues, considering insulinoma.

The diagnosis is relatively clear, because it is not a cardiothoracic surgery disease, so Mr. Huang did not come to attend the consultation.

But at this point, the doctors in the health care team didn't know how to continue.

The diagnosis is clear, there is no doubt, the difficulty lies in the treatment.

If you were decades younger, the doctors in the health care team would definitely decide to perform surgery without hesitation. Whether it is a laparoscopy or a laparoscopy, it doesn't matter.

However, the patient is 88 years old and has a poor physical condition. The risk of surgical surgery is quite high, and no one dares to take this risk.

Under conservative treatment, the patient's blood sugar cannot be controlled at all, sometimes high and sometimes low, and is unstable. Maybe one day at midnight when the patient's blood sugar drops below 1 mmol per liter, and suddenly dies silently.

After a series of consultations, the experts at the meeting were helpless and had to ask Mr. Huang to take a look.

In the health care group, unlike 912, if there are any difficult cases, you will find Mr. Huang as soon as possible.

However, the patient's condition was very special. The diagnosis was clear but the surgical treatment was not possible. The conservative effect was not ideal. Then the General Office called Mr. Huang to find the old man to see if there was any good solution.

When Mr. Huang was sent to the ward, he insisted on checking his body in person, but the middle-aged man grabbed the doctor.

"Director Zhao, Mr. Huang looks bad in his condition." The middle-aged man said in a deep voice.

"I heard that Mr. Huang is okay, and I haven't seen each other for a while. Why is the old man so old?" Director Zhao rubbed his hands and said in confusion. "The last time I saw Mr. Huang was the health care team consultation two months ago. The old man is quite energetic."

"No wonder I'll come later if I have something to do." The middle-aged man said, "Will Mr. Huang be unable to do it?"

He said, his brows frowned even tighter.

"..." Director Zhao sighed.

The middle-aged man had a calm face and covered his anxiety under his serious expression.

"Are there any experts in this field?" asked the middle-aged man.

"The members of the health care team are here," said Director Zhao. "If you find a problem, you have to take a huge risk in the operation... Let's see what Mr. Huang said."

When the middle-aged man thinks of Mr. Huang's old look, he feels distrust in his heart.

Director Zhao also felt confused. Mr. Huang's health has always been good. At the beginning of this year, he completed an epoch-making operation with his closed disciples.

Everyone said that Mr. Huang was an old horse in the stable, but... In a second thought, Director Zhao thought of a possibility.

Mr. Huang doesn’t want to wade into the muddy water!

The patient's illness has nothing to do with cardiothoracic surgery. In addition, his special status, high age, and poor basic status, he should be silent.

Five minutes later, Mr. Huang arched his hands and waist from the ward, and the accompanying health care team experts looked serious.

"Consult, I'll listen to everyone's opinions." said Mr. Huang.

"Her Old Huang, do you have any opinions?"

Mr. Huang didn't say anything, and walked slowly in front of him like an old man who had just been working hard for a day after he had just been in the fields.

Several experts from the health care team looked at each other, and were helpless.

Mr. Huang is either really old or does not want to interfere with diseases that are not related to cardiothoracic surgery, so he doesn't say a word.

Yes, it has nothing to do with cardiothoracic surgery.

When he arrived at the doctor's office, Mr. Huang sat in a corner, his eyes slightly closed, as if he was dozing off.

The experts from the health care team looked at each other again.

well.

But the discussions that should be made must be done. The health care team makes collective decisions. It is his right to not want to speak, but the process still has to go.

"Let me say a few words first." A doctor coughed twice and cleared his throat.

He is the top endocrinologist in the imperial capital.

"The patient has typical symptoms of Whipple triple, which is repeated hypoglycemia, with blood sugar below 2.8 mmol/L at the onset, and symptoms relieved after eating or supplementing glucose.

During the onset of hypoglycemia, INS﹥3 μIU/mL and C-peptide﹥0.6 ng/mL were detected synchronously, supporting hypoglycemia caused by endogenous hyperinsulinemia.”

"In terms of localization and diagnosis, 68Ga-exendin-4 PET/CT imaging and EUS-FNA pathology confirmed the presence of pancreatic neuroendocrine tumors.

Insulinoma may be one of the components of multiple endocrine adenomatosis-1, but the patient has no family history of MEN-1 and has a very old age onset. He has screened for relevant hormone indicators and imaging examinations many times. There is currently no sufficient evidence for MEN-1."

These words are very professional and very... meaningless.

But in the face of such patients, the most meaningless words are to some extent the most meaningful.

In order not to come to the consultation, Mr. Huang refused to say something was wrong, so he pushed him for two hours. After he came, he sat there without saying a word and dozed off.

But Huang Lao has a high status in the world and can pretend to be confused but not by himself.

Then let’s say something completely. After the endocrinology expert finished speaking, he thought helplessly.
Chapter completed!