blenderwars Chapter 361
Chapter 361
Chapter 361
correct,
In addition to the above possibilities,
There is another possibility:
Stomach cancer! !
Because the patient in front of him is in his sixties, the possibility of stomach cancer is still very high.
The next step is to diagnose and eliminate one item.
The first is esophageal cancer:
I can’t find out this question, and I usually need “barium swallow X-ray double-contrast radiography”…
Then there are fish bones and foreign objects.
“Have you eaten fish recently? Or swallowed something that shouldn’t be swallowed? Half a month, a month…”
“No, this is definitely not. I am most afraid of eating fish. I was stabbed when I was young, and I never ate fish with bones again… As for other foreign objects, there must be no…”
Lin Feng nodded.
Temporarily remove fish bones, foreign bodies, puncture blood vessels…
Continue to the next item: ulcers and gastric cancer in various parts of the upper gastrointestinal tract.
“Do you have frequent abdominal pain, nausea, acid reflux, bloating and other discomforts?”
If there is, it is necessary to suspect that it is a gastric ulcer or duodenal ulcer, because these diseases usually have these discomforts, and hematemesis is only one of the manifestations.
result……
Old Liu shook his head repeatedly:
“No, no…I’ve always been fine. I haven’t tried any nausea or discomfort…”
Lin Feng: “………………”
Temporarily rule out ulcers, stomach cancer…
The last item,
Cirrhosis of the liver 047.
“Did you have hepatitis before, such as hepatitis B, cirrhosis, etc…?”
In fact, when asked this sentence, Lin Feng probably ruled it out.
Because patients with cirrhosis of the liver generally suffer from fatigue, weight loss, and dull complexion.
The patient in front of him, Lao Liu, except his face was a little pale, he was actually healthy, energetic, and slightly fat…
No matter how you look at it, I don’t want cirrhosis.
Sure enough, the patient Liu shook his head: “I don’t have these… When my son gave me a group physical examination last year, everything was normal…”
Lin Feng: “???”
This is not,
That’s not there,
What is the reason?
“Or, I will make you a gastroscope?”
“What is a gastroscope?”
Lin Feng patiently explained: “Since you said it was hematemesis, it should be a problem with the digestive tract, but your answer just now made me a little confused. Therefore, I want to make a gastroscope for you and insert the mirror from your mouth. See if there are any problems with the esophagus, stomach, and duodenum…”
Mirror……
In the stomach?
Upon hearing this, the patient Lao Liu was shocked on the spot.
“No, no, I don’t want to do a gastroscope…”
“Why? (aicd)”
“It feels so painful…”
“Don’t be afraid, you can choose painless, anesthetize, and then stretch the gastroscope to go in…”
Even though Lin Feng said so, the patient Liu still shook his head again and again.
Resolutely refused.
“Don’t do it…”
Lin Feng: “……………………”
It’s really unwilling to see the patient like this.
As a doctor, you need to ask the patient’s consent for everything, otherwise it is easy to cause medical disputes.
So Lin Feng will not force the patient to do this…
Since the patient refuses to have a gastroscope, other methods are needed.
The patient vomits blood, which will definitely bleed at any time, then go into shock, and then die.
Therefore, the inspection must not be delayed!
Lin Feng thought for a while: “Why don’t you do an angiogram…”
Then, Lin Feng introduced angiography.
“This is okay, this is okay!”
The patient’s old Liu Yiping only needs to make a hole in his arm and put the catheter into it, even without extensive anesthesia…
Simply great.
“That’s it, radiography!”
Lin Feng: “Before the radiography, I want to tell you about its shortcomings: first, it has certain side effects on the kidneys, of course it is also controllable, and second, it may not be able to find bleeding.”
Because Lin Feng looked at the patient Lao Liu in front of him, he is currently in good condition and he is not vomiting, and the bleeding mouth may have stopped bleeding on its own (but it is still dangerous, time bombs, exploding at any time).
In this case, angiography may not be able to find the bleeding port.
“I’ve decided, just this…”
This patient, Lao Liu, should have some money. He would rather spend money than do a gastroscope.”
Lin Feng: “Okay, I will make arrangements…”
…
20 minutes later,
The patient was transferred to the interventional department and had an angiography…
It took 20 minutes…
The results of the radiography are out!
·No bleeding mouth was found! Nothing!
Lin Feng was disappointed: “Uncle Liu, in your case, you still have to continue doing gastroscopy…”
Patient Liu: “………………”
He really doesn’t want to make a gastroscope by himself!
The older, the more stubborn…
and many more……
At this time, Lin Feng thought of another possibility.
“Nasal bleeding”!
In the nasal cavity, the front end is the nostril, and the back end is the throat.
(King Kong pretty boy gives brother a nasopharyngeal swab·jpg)
There may be bleeding from the nose, flowing back to the throat, irritating nausea, and then vomiting out!
“I look at your nose…”
Lin Feng flashed a torch and observed the patient’s old Liu’s nostrils…
No trace of blood was found.
but,
It is possible that the bleeding is deeper.
“I will make you a “nasopharyngoscopy”…”
This is a medical device for examination of the nasopharynx, throat and larynx, biopsy, surgical treatment of vocal cord nodules or small polyps of vocal cords, and removal of foreign bodies in the pharynx.
Technology: Fiber + Microscope…
If Mr. Liu really had a nosebleed, even if it was not an active bleeding, he could still see the clues through endoscopy.
“Nose? No problem…”
This time the patient Liu did not refuse.
…
10 minutes later,
Old Liu held his tearful eyes, his expression was sour…
· “Nasopharyngoscope” result: no bleeding! !
Ruled out nose bleeding.
This time,
Eventually things turned back to the “gastroscope”.
gastroscopy,
Become the only means.
at this time……
The patient Liu suddenly began to vomit blood.
“Ahem~~~~”
“Crack~~~~”
“Bah! Bah! Bah!”
Then, a few lumps of blood, just like spitting, were spit out by him, and the nurse quickly caught it with a spittoon.
Lin Feng who saw this scene,
Cover your face directly!
“Shit vomiting blood!”
Ten thousand grass and mud horses rushed past!
This is not vomiting blood at all!
Real hematemesis refers to vomiting with blood caused by bleeding in the esophagus, stomach, and intestines. That kind of action will be more violent, and it is definitely not so easy to vomit.
This is vomiting blood, not vomiting blood, and certainly not hemoptysis! !
I was misled by this old Liu!
This old Liu is definitely not the digestive tract, nor the airway, but the mouth! !
It’s definitely mouth bleeding, backflow, and then cough up like expectoration! !
“Open your mouth, let me see…ah~~~”
“Ah~~~”
Although Lao Liu was a little confused, he still opened his mouth very cooperatively.
..