bookpower Chapter 587
Chapter 587
"Send the patient back!" Lin Feng said to Xiaoru.
Not for a while.
Everyone returned to the rescue room.
Lin Feng was stopped by the patient's wife outside.
"Doctor Lin, what's wrong with my husband? ...."
"Don't worry! Not a serious problem! It should be stuck in the esophagus with fish bones! Lin Feng said with a smile.
"How is it possible! Then why didn't he hurt two days ago! The patient's wife had a hard time believing the result.
Lin Feng smiled and did not explain it like him.
Turn around and walk into the rescue room.
After questioning the patient, the same answer was obtained!
I did eat fish two days ago and got stuck.
Then the root of the problem is found.
Why didn't it hurt before?
According to Lin Feng's speculation, it may have only pierced the esophageal mucosa a little, so it did not fall. Then eat today, accidentally pierce the fish bones further into the esophageal mucosa.
The piercing is deeper, so it hurts more.
Pain is also a cause of shock.
However, these are Lin Feng's guesses, and further verification is needed next.
Now the patient's blood pressure is still not stable enough.
Give him more fluids first, plus some drugs to raise blood pressure.
In the latter case, directly observe through the gastroscope to confirm whether it is the fish bones that cause the patient's abdominal pain.
Lin Feng then informed the patient and his family of his treatment plan.
After getting their consent, preparations begin.
Consider the unexpected risks that arise from removing bone spurs.
Lin Feng decided to directly give the patient under general anesthesia for gastroscopic exploration.
Although he does it himself, there are basically no accidents, but there is no fault in care.
Everything is ready.
The gastroscope began to penetrate.
As it slowly progressed, it soon came to the position on the CT image.
It turned out no, but nothing was found.
Lin Feng also took time to watch the film.
Found that this location is right.
Could it be that the piercing is deeper and directly penetrates the esophageal wall!
But it can't be!
Whether he will eat or not, there is no reason why he will pierce deeper!
"Did you fall by yourself? Fell down the esophagus into the stomach? This thought appeared in Lin Feng's mind.
I probed for a while.
Lin Feng could only assume that it was what he guessed.
If it penetrates the wall of the esophagus, then the problem is big, and it is by no means the patient's current performance.
But it's better to do a CT to make sure.
Considering that the patient's current situation could not be done at all, and he had to be wary of really penetrating the esophageal wall and causing heavy bleeding, Lin Feng decided to send the patient to the ICU to ensure the patient's safety.
After removal of the gastroscope.
Lin Feng found the patient's family, explained the patient's current situation, and obtained the consent of the patient's family to hospitalize the patient.
......
After getting this patient, Lin Feng returned to the department.
Turn on the call machine.
After a while,
A big man with a strong back and a bear waist walked in, followed by a male friend, with a bad smile on his face.
"Doctor, quickly help me see..." the big man blushed.
"Sit down and say." Lin Feng said with a smile.
The two sat down.
Patient, male, 29 years old, fitness instructor.
"Where are you uncomfortable?" After the two sat down, Lin Feng asked.
"Dr. Lin, he has a bad waist..." Before the patient could speak, a friend on the side said with a smile.
"Go and go, don't talk nonsense!" The patient muttered to his friend with a look of disgust, and then hurriedly said to Lin Feng: "Doctor Lin, I have back pain!" The whole waist is uncomfortable! "
"Look, I'm right! No, it's still a bad waist...," the friend next to him hurriedly interjected.
Hearing this, Lin Feng immediately gave his friend a serious look and said softly: "Not necessarily! Low back pain is not necessarily a bad back, it may also be caused by other conditions! "
"Other illnesses? Doctor, don't scare me! I'm fine, but my back is uncomfortable..." the patient said quickly.
Seeing that the patient's friend no longer interjected, Lin Feng smiled and said: "Last year, there was a patient with back pain, who just walked out of the emergency room and collapsed, and it was finally confirmed that it was acute myocardial infarction!" "
"Doctor Lin, don't scare me! So what should I do..."The patient was instantly emotionally in place.
"Don't worry! This is not so common! Let's talk about your symptoms first, how long has it been painful? Since when? What caused me not to remember? Seeing that the patient's emotions were in place, Lin Feng soothed.
The patient hurriedly said: "Dr. Lin, I have been in this situation for more than a month. I am a fitness trainer, at first I thought I was a lumbar muscle strain and didn't care, but recently I found that how to rest is useless, so I came to the hospital! As for how it was caused...."
When he said this, the patient looked embarrassed and hesitated.
The friend immediately smiled and said: "Talk about girlfriends!" Day and night are too tiring..."
Hearsay.
Lin Feng looked at the patient and got the answer from his expression.
The patient is a fitness trainer and is in good shape.
The weight of the upper body is not small, so the back pain will be more obvious.
But he didn't know that the patient had back pain caused by lumbar muscle strain.
Then he said, "Let's do an electrocardiogram first!" "
"Dr. Lin, I have back pain, what electrocardiogram do I do?" The patient said in amazement.
"Well, think about the patient who had a myocardial infarction just now!" Lin Feng glanced at the patient, and then said softly: "It is only a dozen yuan to do an electrocardiogram, it is not expensive, and it can also detect many diseases, how good!" "
"Do, do! Dr. Lin, you're right! The patient immediately changed his face and said obediently.
Hearing this, Lin Feng smiled and said to Xiaoru: "Prepare an electrocardiogram!" "
"Yes, teacher!" Xiao Ru replied, and a smile appeared on her face when she saw the patient's reaction.
Although the patient obediently lay on the bed next to him, rolled up his trouser legs, and lifted his shirt to expose his chest, he was still more resistant in his heart.
The last time I did an electrocardiogram, I sucked out red marks on his skin, and it hurt for several days.
Lin Feng could naturally see that the patient was unhappy, and immediately chuckled while moving his hand: "Don't underestimate this back pain, if it is caused by lumbar muscle strain, it is nothing." But what if it's something else! Although the common symptoms of myocardial infarction are chest pain, there are also many back pains! Perhaps it may also be back pain caused by aortic dissection! "
"Doctor Lin, I didn't underestimate it! You're right, it's necessary to do an ECG! I probably don't have some dissection causing back pain, right? The dissatisfaction in the patient's heart at this moment all dissipated, and he asked nervously.
"It's hard to say! You don't have high blood pressure, you're healthy, and you're so young, your risk is much smaller. But to really rule it out, it still needs to be examined in detail to be sure! Lin Feng said softly.
Speaking of which.
The patient stopped talking.
Soon
The ECG results came in.
No problem, not a myocardial infarction.
The next step is to rule out aortic dissection.
The patient is given a blood pressure measurement in both arms.
Blood pressure in the left arm 140/80mmHg
Blood pressure in the right arm 135/76mmHg
Basically symmetry!
However, this does not exclude aortic dissection.
If the patient's aortic dissection involves only the thoracic and abdominal arteries and not the upper artery, the blood pressure in the left and right arms can be completely symmetrical.
"Doctor Lin, how's it going? After measuring his blood pressure, the patient hurriedly asked.
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