blenderwars Chapter 384
Chapter 384
Chapter 384
The ECG monitor shows that everything is normal for the patient’s physical condition.
Lin Feng frowned.
“Did you vomit this blood from your stomach or cough up from your airway.”
To confirm, Lin Feng asked the patient Zhang Chen again.
Zhang Chen: “It’s nausea, vomiting…”
Lin Feng: “That’s vomiting blood…”
“Have you had stomach ulcers, duodenal ulcers, liver cirrhosis, hepatitis B, alcoholism before?”
Lin Feng asks this because the hematemesis of most patients is related to gastric ulcer, gastric cancer or liver cirrhosis.
“No, not at all.” Zhang Chen shook his head and replied.
“Have you had bloating before?” Lin Feng asked.
“For a while, last month, about a week or so, I didn’t eat much, but my stomach was a little bloated… Could it be related to my vomiting blood?”
Lin Feng nodded: “There is a possibility…”
Among them, cirrhosis of the liver can cause stomach swelling, and cirrhosis of the liver can cause hematemesis.
·Principle: Because the blood in the esophageal and gastric fundus veins needs to pass through the liver to enter the heart 08, if the liver is cirrhotic, the blood vessels will be narrowed, and the blood flow will definitely not be smooth. Over time, the esophagus and stomach veins will become varicose and excessive varicose It may rupture and bleed.
“I’ll check your abdomen… don’t tighten your belly…”
Lin Feng carefully checked,
Because the patient only said that he had low back pain, Lin Feng didn’t examine the abdomen carefully. This was Lin Feng’s mistake.
Lin Feng gave Zhang Chen a simple check of the abdomen:
·Abdominal swelling is not obvious (inference: there is no major bleeding)
·The stethoscope found that bowel sounds were more active (inference: the increase in fluid may be due to gastrointestinal bleeding…)
“Forget it, first blood transfusion, rehydration, use some hemostatic drugs to prevent the patient from vomiting blood again, to prevent shock…”
Finding the cause is definitely not so fast, so stop bleeding and resist shock first. This is a must.
Lin Feng asked the nurse to dispense some medicine,
The nurse quickly dispenses the medicine, the infusion…
While infusion,
Because the patient Zhang Chen’s ECG monitor has been very stable, Lin Feng made a decision:
He said to Zhang Chen:
“Now your condition is fairly stable, so take the opportunity to get an abdominal CT to see if there is liver cirrhosis, liver cancer or other conditions…”
Zhang Chen has become a frightened bird because of hematemesis.
He would not object to what Lin Feng arranged to do.
“Okay, Dr. Lin, you just have to arrange it!”
“Lin Feng explained, do you usually drink a lot of alcohol?”
Drinking alcohol can cause liver cirrhosis…
Zhang Chen shook his head: “Drink occasionally, not much.”
Lin Feng nodded: “I open an order, and then the nurse pushes you to do CT…”
“Yes……”
…
The nurse carefully pushed the patient Zhang Chen to do the CT. Because it was a jump in the queue, the result was presented on the spot, and then the electronic data was uploaded to the hospital database.
Lin Feng called here,
Reading CT.
Soon, Lin Feng breathed a sigh of relief.
·No cirrhosis, no liver cancer…
·But there is a little ascites…
Lin Feng said to Zhang Chen: “Congratulations, it’s not liver cancer… nor cirrhosis…”
Zhang Chen breathed a sigh of relief.
“so far so good……”
If it is really liver cancer, he probably wants to die.
The girlfriend also breathed a sigh of relief at this time.
At this time, Lin Feng said:
“Since it’s not liver cirrhosis or liver cancer, you have to see if it is gastroduodenal disease, such as ulcers… This can be seen clearly only after a gastroscope… Don’t worry, it can be anesthetized, it is painless…”
“Okay, the gastroscope is just the gastroscope…”
Zhang Chen is very obedient…
After all, he only vomited blood soon, and he still wanted to save his life.
At this time, Zhang Chen’s girlfriend asked, “Dr. Lin, are there other possibilities for vomiting blood?”
Lin Feng: “There are indeed other possibilities, such as problems with the esophagus: foreign bodies, esophageal cancer, but your boyfriend just said that he didn’t feel any abnormal sensation in his throat, so it should be a stomach or duodenal problem… And, do Gastroscope, you can see the esophagus, stomach, and duodenum all the way…”
At this time, Lin Feng thought of the anemia of the patient Zhang Chen.
“By the way, have you had blood in your stool lately? That is black, red stool…”
“No……”
Lin Feng nodded.
There is no vomiting blood before, no blood in the stool, indicating that there is usually less bleeding or bleeding for the first time.
…
The patient agreed to do a gastroscope,
Then Lin Feng began to arrange the operating room.
Yes,
Arrange the operating room, not send it to the gastroscopy room.
Because of fear of heavy bleeding in the middle, or a bleeding mouth in the middle, he can stop bleeding under gastroscopy.
Once a major problem occurs, it can be rescued in time, so I can’t go to the gastroscopy room, but go to the operating room.
Sent to the operating room,
anaesthetization……
Start gastroscopy…
but,
When Lin Feng operated the gastroscope, he found the bleeding point.
· Not a gastric ulcer or duodenal ulcer,
·On the contrary, the “esophageal varices” is severe, very obvious, and bleeding is seen! !
Lin Feng was stunned!
its not right!
Didn’t the previous CT rule out liver cirrhosis?
How come there are “esophageal varices”?
has a problem! !
063
At this moment, the interns who came to watch were frying.
“what happened?”
“Generally speaking, there is no cirrhosis of the liver, which means that there is no bleeding from esophageal and gastric varices.”
“Yes, varicose veins in the fundus of the esophagus and stomach are caused by cirrhosis of the liver…”
“what is the problem?”
Have wondered.
Then look at Lin Feng.
They expect Lin Feng to find out the answer!
Since it is bleeding, do a microscopic hemostasis.
This is the basic exercise for Lin Feng.
The specific method: “Ligament hemostasis treatment”, that is, the bleeding mouth is tied up with rubber bands.
Tied up,
Then the blood stopped.
Although the bleeding was stopped, the cause of hematemesis was found.
but,
Two huge mysteries are still there.
·What is the cause of low back pain and dizziness?
·Why there is no cirrhosis of the liver but varicose veins of the fundus of the esophagus and stomach?
Many interns are full of confusion and curiosity…
But Lin Feng already has an idea in his mind!
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ps: Three shifts are here.
ps: The above two questions are caused by the same disease. The answer will be announced in the chapter tomorrow. .