Doctor Started a Plug-in

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The case is not long.

Just a few words.

But a lot of information can be seen.

Doctors sometimes just see a few medical records.

The first is to find the cause according to the symptoms, and the second is to push the symptoms according to the cause.

Patient’s symptoms at this time do not seem to be difficult for short legs.

In terms of symptoms, the patient may suddenly experience dizziness, weakness, etc., which should be a manifestation of low blood volume, and there are also irritation symptoms such as sudden abdominal pain, bloating and other intra-abdominal bleeding!

Signs: There is pulse rate, low blood pressure, and obvious signs of peritoneal irritation, which should indicate intra-abdominal lesions.

Blood routine showed that the incidence of Early-Stage hemoglobin decreased progressively, but MCV and MCH did not change significantly, but Fib continued to be low and D-2 aggregates increased significantly. These seemingly messy laboratory test reports can obviously draw a conclusion , Fully consistent with the performance of acute blood loss!

So Chen Cang said directly: “Consider acute bleeding disorders!”

Chen Cang’s diagnosis was almost directly given after the case was finished.

Several directors looked frequently, full of appreciation.

Although this diagnosis is not difficult, but… you need a certain level to get acute bleeding so quickly.

And Chen Cang basically blurted out, which shows the solid foundation of the other party!

Huang Qiuying cannot to bear nodded: “Yes, since it is a hemorrhagic disease and it is pain in the lower abdomen, physical examination and imaging have found that the solid mass is accessible in the pelvis, and the Patient itself has a history of gynecology, so I first consider Gynecological related diseases.

There are only a few diseases that can cause bleeding in gynecological diseases!

The first is pregnancy-related diseases: such as ectopic pregnancy, trophoblastic tumors, etc.;

The second is the rupture of ovarian or fallopian tube tumors;

Finally, the ovarian endometriotic cyst ruptures. “

Chen Cang nodded: “Patient has been able to rule out pregnancy-related diseases for many years after menopause, and endometriotic cysts are also unlikely!”

Thinking of this, Chen Cang suddenly asked: “Patient fell?”

Cui Jisheng nodded: “Yes, but… it just slipped gently to the ground.”

Sliding gently to the ground is not the same as thinking hard.

Huang Qiuying said: “Before the diagnosis of bleeding caused by gynecological diseases is established, bleeding from other systems and other reasons needs to be ruled out.”

As the director of General Surgery, He Zhiqian said, “We have discussed before that surgical bleeding in the abdomen is generally seen in organ injuries.”

“But damage to parenchymal organs such as liver, spleen, pancreas, etc., hollow organs such as stomach, intestine, and gallbladder bile duct; in addition to blood vessels such as abdominal aorta, inferior vena cava, etc. Generally these injuries are continued It is caused by severe closed injury or penetrating injury. The damage of pelvic blood vessels is mostly secondary to penetrating injury, pelvic or lower limb fracture.

Therefore, the Patient only slowly falls to the ground after slight activity, and there is no obvious fracture manifestation, and generally it will not cause damage to the above organs and tissues. “

He Zhiqian’s remarks directly denied the possibility of Patient’s organ damage.

Next, urology, hematology, endocrinology, and interventional departments began to discuss again.

Perhaps many people do not understand what a consultation is?

This is the consultation, giving an inferred diagnosis, and then the various departments to diagnose.

This is the benefit of branching.

Every doctor is proficient in one field!

They are very good at diseases in their field.

Continuously reduces the Patient probability.

An acute hemorrhage in the abdominal cavity may seem ordinary, but now a clear diagnosis cannot be given.

In fact, this is medicine.

As one of the founders of Johns Hopkins Medical College, Sir William Osler said: “Medicine is an uncertain science!”

The discussion at this time was anxious again.

Urology has rejected the possibility of damage to the patient’s bladder area, and temporarily does not consider urology-related diseases.

The hematology’s inference is focused on blood vessel injury. After all, chronic blood vessels and other chronic diseases secondary to blood vessel lesions can easily cause bleeding.

Another round of discussions ended.

Everyone was silent again.

Generally speaking, consultation is actually a step-by-step process.

If the situation is diagnosed, this is easy to say.

but……

If this is the case today, when everyone discusses for half a day but cannot find the cause.

Consultation will not be wasted!

The consultation will gradually become a push pot conference.

After all, such a difficult patient, the diagnosis is now unclear, let alone treatment.

In fact, it can only be said that the Patient situation is okay.

If it is really critical, the 1st Step may be to perform a laparotomy.

Sometimes, imaging studies have limitations.

There must be some bleeding, but the amount of bleeding is not very large.

At this moment, there was silence again in the office.

Huang Qiuying was also decisive: “Notify Operation Theatre and prepare for laparotomy!”

Now it makes no sense to drag on.

At this time, Chen Cang was continuously thinking about various possibilities.

The routine diagnosis has been fully thought through, but… but it does not meet the symptoms of Patient.

No wonder everyone has consulted and discussed for an hour without results.

At this time, Chen Cang suddenly said, “Can I go to see the Patient?”

Huang Qiuying turned to look at Chen Cang, and then thought that Chen Cang hadn’t expressed any opinions since he came.

Everyone also thinks that this kid Chen Cang… will not come to the show? !

But no one will force Chen Cang, after all, they are just a training doctor.

If you don’t give it, he is not responsible.

but……

To be honest, these directors certainly do not believe Chen Cang can give the results.

Huang Qiuying saw Chen Cang’s serious look as if she was not pretending to be in a pretentious manner. She could not help but stunned for a while: “Okay!”

While speaking, Huang Qiuying personally took Chen Cang to the ward.

An old lady in her 60s was lying on the bed, moaning her stomach uncomfortably.

Seeing Huang Qiuying coming, was about to speak, and suddenly saw Chen Cang!

Suddenly, the old lady blushed: “Professor Chen!”

The old lady’s husband, Cui Jisheng, unable to bear said: “Wife, don’t worry, Professor Chen can definitely diagnose it!”

The old lady was nodded, and suddenly felt that her stomach was not so painful: “Yes, yes! I believe Professor Chen!”

Chen Cang is also sighed, the pressure is great!

Only love and trust cannot be let down!

The directors around have different expressions.

If Chen Cang had a clear diagnosis, it was really capable.

But… to be honest, this disease really needs to be as simple as it is now.

This kind of bleeding is absolutely rare!

As expected, Chen Cang was in a stalemate after palpation, and was unable to get an accurate answer for a long time!

However, Chen Cang’s eyes are not perspective after all.

There is no way to see the situation in the abdominal cavity.

Patient’s pelvic hematoma seems to be an unsolved mystery.

Time passes by every minute!

Chen Cang is also thinking hard!

What are the acute abdomen?

His mind is like a search engine, continuously bringing in, thinking, and speculating repeatedly.

Chen Cang suddenly thought of something, and quickly said: “Be a vein in upper and lower limbs Color Doppler Imaging!”

Huang Qiuying frowned: “The upper and lower limbs? What’s the point?”

After hearing the words of Chen Cang, the Doctor of Intervention Department couldn’t help but twitched eyelids!

“Yes, be a Color Doppler Imaging!”

Hearing the intervention of Doctor, Huang Qiuying is not blocking.

Gynecology itself has ultrasound, and soon the results came out!

Blood vessels Color Doppler Imaging of the upper and lower limbs also prompts thrombosis of the right femoral and popliteal veins!

Everyone who saw the result was a little dazed.

But Chen Cang was scared at this time brow beaded with sweat!