bookpower Chapter 524
Chapter 524
It took more than 2 hours,
The patient's MR results are finally out.
As a result, Lin Feng breathed a sigh of relief.
· MR: Tumor in the spinal canal of the patient's 9th thoracic spine!
Because of tumor compression, the patient's spinal thalamic tract and pyramidal tract are affected, and abdominal pain and abnormalities in lower limb muscle strength appear.
But......
Why are there white blood cell abnormalities?
Theoretically, elevated white blood cells should be the cause of inflammation, which seems to have little to do with tumors.
Therefore, it is very likely that the patient also has "appendicitis"!
That is: neuraxial tumor + appendicitis, all at the same time.
At this point,
The patient and the husband are confused and afraid.
"Doctor Lin, what should I do?"
Full of helplessness, and fear of tumors.
Lin Feng: "I can only do surgery, direct surgery, open a knife from the back, cut off the tumor..."
Then explain the operation.
This operation sounds quite difficult, but it is still hand-to-hand for Lin Feng, and in the operation that Lin Feng has experienced, the difficulty is not even the top hundred.
As for appendicitis... At present, there is only a slight change, but it is not really sure that it is appendicitis, and it is necessary to be hospitalized for a few days to see the development of the disease.
"Hospitalized..."
Admit patients to the hospital...
......
Afternoon.
Lin Feng off work.
Then share this case with the emergency department work group.
It has attracted a lot of attention.
"This disease is interesting..."
"It's easy to confuse, when we diagnose appendicitis in the future, we should be careful."
"Very educational."
"I encountered this disease 5 years ago, the patient was first diagnosed with acute appendicitis, and he was admitted to the hospital for an appendectomy. But after appendix surgery, she still often feels that she will have right lower abdominal pain, accompanied by abdominal distention, repeated attacks... I had a lot of examinations around her abdomen, what abdominal CT, abdominal MRI, abdominal ultrasound, gastroscopy, colonoscopy, gastrointestinal angiography and other examinations, I thought about it, but I couldn't find any problems... Later, it was found that after using adrenocortical hormones, the pain would be relieved... Finally, through MR, it was discovered that it was a spinal tumor that compressed the nerve..."
The group became lively.
are discussing these 2 peculiar cases.
"Wow, this disease is interesting..."
Mengxin asked curiously: Why do glucocorticoids reduce pain?
"Because hormones can reduce the edema of the spinal thalamic tract, nerve compression will be relieved, and pain can be relieved, so the use of hormones has an effect..."
"Of course, this disease is still relatively rare, and we have only encountered this one that Dr. Lin encountered in the emergency department so far..."
"It's still Dr. Lin, I found it once, unlike me, who did a lot of tests to find that the patient spent nearly 10,000 examination fees... Fortunately, the patients were grateful to me in the end and didn't feel that I plagued their money..."
"Dr. Lin is indeed awesome..."
“666......"
Soon, these two cases spread to other departments, especially gastroenterology and oncology, causing great discussion.
......
......
The next day,
Today, the sky is gray in the imperial capital, and it is estimated that PM2.5 is not small.
In one of the families,
A 10-year-old girl is crying urgently.
"It hurts... It hurts... Mom..."
Mom cried.
Since yesterday morning,
Her daughter Lele suddenly developed symptoms of fever, nausea, vomiting and diarrhea.
The family was terrified and grateful for taking her to a nearby community hospital.
After the consultation, the doctor thought she was suffering from acute gastroenteritis and prescribed some medicine for her.
However, after the little girl returned home, the abdominal pain became worse and worse.
He also thought that it should be okay to take medicine, so he didn't go to a big hospital.
One drag, it's a day.
This morning, Lele's condition became more serious, his stomach was constantly swollen like a bulge, and the fever temperature was as high as 40 degrees.
Seeing their lovely daughter become like this, Mom and Dad were heartbroken.
"Husband, go to the hospital now, you can't delay."
"Go, right away!"
Mom and Dad began to quickly pack up their things and prepare to go out.
Grandma shouted in the kitchen: "Lele hasn't eaten breakfast yet... I've already fried her favorite poached egg..."
Loose heart poached eggs, that is, poached eggs with uncooked yolks, cooked on the outside, and the egg liquid flows out inside...
And Lele's favorite breakfast is poached eggs with candy hearts.
I love it every day for breakfast.
Grandma also practiced the practice of poached eggs with sugar hearts, and the technology gradually became first-class.
Dad hurriedly said: "I can't eat it, now the baby's stomach is uncomfortable, and it's more troublesome to eat..."
Grandma said: "If you don't eat, you have no strength, and it's more troublesome to get sick..."
Finally, Grandma packed the poached eggs and stuffed them into Dad's hands.
"Bring it, if you are hungry in the hospital, you can eat it..."
"Well..."
soon
The little girl Lele's parents, drove Lele, sent Lele to Harmony Hospital.
And the receiving doctor happened to be Lin Feng.
......
In the consultation room,
Lele lay on the bed, curled up, cold sweat...
"Tell me about the situation..."
Lin Feng asked while putting on gloves.
Mom: "It's like this... Lele didn't know why he suddenly had a stomachache since yesterday..."
Tell the story...
Lin Feng put on his gloves and came to the bed.
"Little sister Lele, the doctor uncle will give you a check-up, can you relax?"
"Well..."
Lele nodded with difficulty, sweat already soaking her hair.
1 minute later...
Check out.
There is pronounced abdominal muscle tension,
• There is total abdominal tenderness and rebound tenderness.
・The belly is a little bulging, hard ...
Lin Feng was initially diagnosed with "acute peritonitis".
"peritoneum",
It is a layer of membranous tissue, the peritoneum covers most of the organs in the abdominal cavity, can secrete mucus to moisten the surface of the organs, reduce the friction between the organs.
It's not the same thing as the gut.
The intestine is wrapped in it.
The physical examination results of the little girl Lele in front of him are typical features of peritonitis.
So why does the peritoneum become inflamed?
Cause:
・ Organs such as gallbladder and stomach are perforated, there is fluid exudation, bacteria multiply in the peritoneum...
Perforation of the intestines, feces and urine flowing into the peritoneum, causing inflammation ...
· Other...
Consider another sign: bulging abdomen, hard and should be gas.
That should be intestinal perforation, where gas + fluid enters the peritoneal area, causing inflammation.
And here's the problem.
What did you eat?
Causes intestinal perforation?
Lin Feng: "Have you eaten anything special recently?" "
Mom: "Something special?" No..."
Dad: "Yes, Dr. Lin, we pay attention to what we give our children to eat, we will not give her random food, they are all healthy meals made at home... And we all eat, it's okay..."
Lin Feng nodded: "At present, it should be acute peritonitis... Go for a "blood routine" + "X-ray"..."
Lin Feng opened the bill.
The parents quickly took Lele to go for the examination.
......
/