bookpower Chapter 565
Chapter 565
Reach out and prepare to check Uncle's belly.
He simply pressed a few times, and asked while pressing: "Does this hurt?" And here? "
After getting feedback, withdraw your right hand.
There is no significant bloating, no significant tenderness, rebound tenderness.
After listening to the lower bowel sound, it is basically normal.
"Doctor Lin, how is my dad...," the son on the side hurriedly asked when he saw Lin Feng finish his examination.
"Preliminary examination, I can't see any problems, first go to draw blood and take a film." Then come and find me! Lin Feng said softly.
Mild abdominal pain.
On initial inspection, it is true that nothing can be seen.
"Yes, Dr. Lin! I'll take my dad with me..." the son on the side hurriedly said.
......
An hour later.
The two came to Lin Feng again.
It just so happened that he had just sent away a patient.
"Dr. Lin! This is a checklist and a piece, take a look..." After helping the uncle to sit down, he handed the checklist and film he was holding to Lin Feng.
Blood routine: everything is normal.
Abdominal piece: no symptoms were found.
Based on the results of these two tests, the patient's condition is not consistent with the common surgical acute abdomen such as acute appendicitis, acute cholecystitis, cholangitis, pancreatitis, intestinal obstruction, intestinal perforation, urinary stones, etc.
"Doctor Lin, how is it...?" the son on the side asked anxiously.
"From the results of the examination, nothing unusual was found. Your father has no history of gastrointestinal history, I will first prescribe some antispasmodic drugs, and then take it to see the effect! After Lin Feng finished speaking, he prescribed the medicine.
"Yes, Dr. Lin! Thank you! Uncle's son hurriedly thanked him.
"You're welcome, go get the medicine!" Lin Feng smiled.
After sending this patient away.
Lin Feng took advantage of the fact that the next patient had not yet come in.
Start thinking in your mind about what will be taught to them tomorrow.
Greed for more does not rot!
It is better to start with the importance of electrocardiograms.
......
Just when Lin Feng was about to leave work,
"Dr. Lin! Dr. Lam...."
At this time, Lin Feng saw that the uncle in the afternoon was brought by his son again.
The expression on the uncle's face looked a little painful.
Lin Feng immediately greeted him and helped the uncle to sit down.
"What's wrong? The drug is not working? Seeing the appearance of the uncle, Lin Feng immediately asked.
"Dr. Lin! When I got home, I asked my dad to take the medicine. It was fine at first, but it didn't take long for him to say that his stomach hurt more and more, what the hell is going on..." the uncle's son said with a worried face.
Hearsay.
Lin Feng immediately thought in his heart that this uncle was definitely not simply acute gastroenteritis.
Antispasmodic drugs are useless!
No symptoms can be seen on the test sheets and films.
He immediately asked, "Don't worry!" What medical history your boss has before, tell me well! "
"Dr. Lin! My dad has diabetes...."
"And?"
"Hmm! And atrial fibrillation....."
Hearing this medical history, Lin Feng was immediately shocked.
Suddenly angry.
"Why didn't you say it earlier!!"
Lin Feng scolded while also blaming himself for not asking about his medical history.
Atrial fibrillation is the most common persistent arrhythmia. The frequency of atrial agitation in atrial fibrillation reaches 300~600 times / minute, and the heartbeat rate is fast and irregular, which is not only faster than normal people, but also very uneven, so that the atria lose effective contraction function.
When the atria loses its effective contractile function, blood is easy to stagnate in the atria to form a thrombus, and after the thrombus is shed, it can spread throughout the body with the blood, resulting in cerebral embolism (stroke), limb artery embolism (severe cases even require amputation), etc.
Thinking of this, Lin Feng immediately asked: "Uncle, did you take warfarin on time for your atrial fibrillation!" "
"Nope! Eating every day, it's too troublesome..." said the uncle immediately.
Really!
Warfarin is an anticoagulant, the purpose is to prevent atrial thrombosis, enlargement, if you do not take the drug, it is likely to happen today!
The answer is coming soon!
"Superior mesenteric artery embolism"!
Lin Feng thought of this situation for the first time.
This uncle did not take warfarin normally, resulting in atrial thrombosis, and the blood clot flowed down the blood to the mesenteric artery, which caused embolism of the superior mesenteric artery, resulting in ischemic necrosis of the intestine.
The superior mesenteric artery specifically supplies blood and oxygen to the small intestine, where embolism is blocked, the blood vessels behind it will naturally be ischemic, and the intestine will naturally die.
Therefore, patients will have abdominal pain, bloating, blood in the stool and other manifestations.
Lin Feng immediately asked again, "Uncle! You really don't have blood in your stool, don't you? "
"Nope! Definitely not...," the uncle said again.
Lin Feng was silent for a moment.
Then said: "Sir, your situation is somewhat special, I suggest you do a abdominal contrast CT!" "
"Yes, Dr. Lin! Listen to you..." The son of the uncle was holy to Lin Feng's words.
Hearing this, Lin Feng said to Xiao Ru: "Xiao Ru, you take the uncle to the CT room first, and I will go through the procedures with the uncle's son!" "
"Yes, teacher!" Small as the answer immediately.
Then he helped the uncle out.
"Doctor Lin, what should I do...?" the uncle's son asked impatiently.
"Don't worry! Uncle was there just now, I didn't explain it! Now tell you, I suspect that uncle is embolic in the superior mesenteric artery at this time, if not treated in time, his intestines may be gone, but uncle has diabetes, if CT contrast is strong, contrast agent is not good for his kidneys! Lin Feng made a long story short and explained.
"Doctor Lin, I listen to you! Do you think you should do it..." The uncle's son was also very crisp and directly handed over the decision to Lin Feng.
"I think it has to be done! Even if there is some damage to the kidneys, it must be done! Lin Feng said immediately.
"Then do it! Dr. Lin, I trust your judgment..."
Most like such patients!
Have the greatest trust in the doctor!
Unlike some patients who have been ill for a long time, they have a little understanding of pharmacology and question the various diagnostic and therapeutic methods of doctors.
Explain, they don't understand very well!
Don't explain, they're not happy to accept it yet!
。