bookpower Chapter 709
Chapter 709
The patient said yes though.
But he still wanted to struggle in his heart, so he said to Lin Feng: "Doctor, but I didn't have stomach ulcers before!" Usually my appetite is quite good, but this time is not very good, but there is no stomach acid, acid reflux water! "
Lin Feng smiled and said softly: "Many people with stomach problems do not necessarily have symptoms!" It is not discovered until vomiting blood or stomach cancer. "
Swish~
Hearing about stomach cancer, the patient immediately stopped quibbling and immediately said: "Understood!" Then let's go now, I just heard that doing gastroscopy is very uncomfortable! "
"We use anesthesia and do painless gastroscopy!" Lin Feng explained, and then continued: "I want to inform you first, you don't necessarily have a stomach or duodenal problem that causes vomiting blood now!" Do a gastroscope to see clearly and determine whether it is or not! It may also be other bleeding that may result, such as if you vomit, it may be a laceration of the esophageal mucosa, esophageal cancer or biliary bleeding caused by severe vomiting. The causes of hematemesis are complex, and hospitalization may be required depending on the situation. "
The patient nodded quickly, he just wanted to hurry up and go to the gastroscope.
I was afraid that Lin Feng would say some more serious diseases.
There is no objection to seeing the patient.
Lin Feng immediately called Xiao Ru aside and arranged for her to go to the ICU to coordinate.
The patient has gastrointestinal bleeding, the probability is gastric ulcer or liver cirrhosis, esophageal variceal bleeding, and the problem of gastroduodenum is also very large, because abdominal CT does not see cirrhosis.
Wait to enter the operating room for gastroscopy, if necessary, stop bleeding under gastroscopy, and it is very likely that you need to go to the ICU to strengthen monitoring and treatment after surgery, just in case you can't stop the bleeding, so as to continue rescue.
This cannot be said to the patient and the patient's family, so Xiaoru is pulled aside.
Hearing Lin Feng's arrangement, Xiaoru quickly nodded and ran out of the rescue room.
Not for a while.
Came back again, leaned into Lin Feng's ear and said: "Teacher, the ICU has been contacted, and there will be an empty bed, which can be lived in at any time." "
Lin Feng nodded.
Everything is ready.
Gastroscopy is then started.
The patient was also very powerful, and did not vomit blood again during the operation.
However, the blood draw results came out, and the patient's anemia was more serious.
Hemoglobin is only 69g/L, and the normal value is 120-150, which should be bleeding a lot.
Although he did not vomit blood again, it was not ruled out that the bleeding rate was slow and flowed towards the intestine.
No surprises.
The patient will soon have a black stool.
After the blood passes through the digestive tract, it will turn black after absorption and decomposition.
Soon.
The gastroscopy procedure was very smooth.
But the result was unexpected by Lin Feng.
Go to the mirror.
Lin Feng was a little puzzled, and after looking for several times, he did not see obvious gastric ulcer or duodenal ulcer, but the esophageal varices were very strong, which was very obvious.
After all, the patient's CT did not see cirrhosis, and in general, there is no cirrhosis, which means that there is no possibility of esophageal and gastric variceal bleeding.
In the vast majority of cases, esophageal varices are due to cirrhosis.
Because the blood in the esophageal and gastric fundus veins has to flow back to the liver to enter the heart, if the liver is cirrhosis here, the blood vessels become narrow, and the blood must not flow smoothly.
Over time, the esophageal and gastric fundus veins become varicose and excessive varices may rupture.
Now the gastroscope has seen the patient's esophageal varices ruptured, the tear is very obvious, and the blood continues to slowly and continuously.
Immediately.
Lin Feng did a banding of the ruptured and bleeding vein to stop bleeding.
Simply put, Lin Feng tied up the bleeding mouth with a blood rubber ring, and the blood stopped.
For the safety of patients.
Still according to the previous arrangement, the patient was directly sent to the ICU after the operation.
Blood was also sent from the blood bank, blood transfusions were given to patients, more fluids were added, and some hemostatic drugs were used.
It's just that Lin Feng is still wondering.
The patient obviously does not have cirrhosis, why does esophageal and gastric varices appear!
When the patient's condition improves, he plans to review the patient's treatment process.
One night passed.
The patient finally got through it safely.
The next day.
Lin Feng began to improve the cause of some common liver cirrhosis tests for patients.
For example, whether there is Wilson's disease, immune-related cirrhosis, parasitic diseases, and so on.
A lot of inspections were done, but still nothing was found.
Until this moment.
Lin Feng has determined in his heart that the patient's esophageal and gastric variceal bleeding has nothing to do with cirrhosis.
The patient has no cirrhosis at all, and there are no diseases that commonly cause gastrointestinal bleeding, such as gastric ulcers and duodenal ulcers.
However, Lin Feng also observed two situations that he ignored.
The patient has mild ascites and a somewhat enlarged spleen.
In general, ascites, splenomegaly, and esophageal varices are characteristic of cirrhosis.
The blood of the spleen also has to pass through the portal vein of the liver to come back, if the liver is cirrhosis, the portal vein must be affected, the portal vein pressure becomes greater, the blood in the spleen does not come back smoothly, and the spleen will also become larger.
Although the patient has ascites, mild splenomegaly, and portal hypertension, cirrhosis is not seen.
This suggests that the patient has non-cirrhosis portal hypertension.
Noncirrhosis portal hypertension is much less common than cirrhosis portal hypertension.
However, this is the case clinically.
It's not that the diseases you see are common.
There will always be some rare situations that happen, and if you don't know them, something will happen.
As for what causes non-cirrhosis portal hypertension, further examination is required to know.
The gastroscopy is done.
But the patient did not hear Lin Feng tell him what kind of illness he had.
It's just that hearing about yourself is more complicated.
I couldn't help but start worrying again, worried about whether I would vomit blood again.
For the patient's worries, Lin Feng also comforted him.
Subsequently, outside the ICU.
Lin Feng explained the situation carefully to the patient's wife.
I heard Lin Feng say that her husband may bleed at any time later.
The patient's wife was very nervous.
It is necessary to inform the patient's family of the true condition.
Not telling the patient is not wanting the patient to have too much stress.
Informing the family requires the family to be careful about any emergencies of the patient and be mentally prepared for these emergencies.
After comforting the patient's family for two more words, Lin Feng left first.
The next time.
The patient did not hematesis again, which made Lin Feng somewhat relieved.
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