bookpower Chapter 325
Chapter 325
Intervention is a good way to do it.
It can help find the bleeding focus and stop the bleeding quickly.
Of course
Intervention is not a panacea, and it may not be possible to find bleeding foci, or even if found, it may not stop bleeding well.
Even when stopping the bleeding, the road may be blocked before the bleeding port, causing road embolism and posterior tissue infarction.
Even, contrast agents can have certain side effects.
But
For now, the best way is to get involved.
Of course, there is another method: open surgery, in which the intestines are taken out section by section and examined little by little.
"Sir, the current method is to intervene and caesarean section... It depends on how you choose..."
The husband did not hesitate:
"My wife loves beauty, she shouldn't like scars on her stomach, so let's try to intervene first... Please, Dr. Lin, I know you're the best. "
"Don't worry, I'm still familiar with the intervention."
The patient's husband thanked and prayed for his wife to get through.
After signing...
Then sent to the interventional section.
Push into the interventional operating room. (Interventional surgery is not considered surgery.) ）
......
In the operating room,
The patient is lying on the hospital bed,
The contrast machine is turned on,
Lin Feng and other doctors and nurses anesthetists, put on lead clothes...
Outside, there are ICU and other doctors, all waiting for the results of the intervention.
They were all curious about where the bleeding point was!
Lin Feng's movements are sharp,
The contrast agent is quickly pushed into the arteries,
10 minutes later...
As a result, interventional imaging was disappointing.
Lin Feng repeatedly made an image, but he didn't see where the blood vessels ruptured and bleed, not to mention the obvious opening, even the tiny opening.
Lin Feng looked at the patient's bottom.
A problem came to mind, and when the patient was brought to the interventional department, there was no more bleeding.
"Could it be that the bleeding has stopped the bleeding?"
"So you can't find it with imaging?"
Lin Feng's heart of 10,000 grass and mud horses rushed past.
What a pit!!
Don't think it's good that your body stops bleeding on its own!
Because this degree of hemostasis is very fragile, it may break out again at any time.
It's like a ticking time bomb that can explode at any moment.
In case the patient is not sent to the hospital in time outside, it may be sent directly to the morgue.
......
failed intervention,
Lin Feng withdrew the contrast catheter to stop the bleeding...
End the intervention.
Push the patient out of the operating room,
Outside the door, the patient's husband ran over nervously: "Dr. Lin, how is it?" "
Lin Feng: "I'm sorry, I didn't find the bleeding hole..."
The patient's husband: ".................."
Pit ah!
Lin Feng thought for a while: "Otherwise, let's do a CT..."
There is no way to intervene, then you can only try CT.
Anyway, they all came out of the ICU, so why not go to the CT room.
......
After 10 minutes,
Arrive at the CT room.
Many patients waiting for CT outside saw the hospital bed pushed over, and also knew that the condition was urgent, so they got out of the way, and did not scold the 'cutting dog'.
Lin Feng personally went to CT.
Chest, abdomen...
Read it all.
Luckily, there was no tumor or anything like that.
But it also means that Lin Feng did not find anything that could cause bleeding...
No, there is a place!
Stone!!
The pancreatic duct of the female patient Wang Jiali has a small stone.
The size of a bean.
If there is any abnormality in the whole body, this is the position.
"Could it be that the stone broke the pancreatic duct and then caused bleeding???"
After the CT is done,
Preparing to return the patient to the ICU...
Then
I don't know if it's because of the move...
Lin Feng saw that the patient's underneath was wet and blood-red.
Bleeding again!
Dried blood, mixed with blood!
Lin Feng moved.
"Go, go to the intervention department again!!"
Lin Feng explained to the patient's husband: "I didn't find the bleeding point just after I intervened, maybe because the bleeding has stopped, and now there is blood again, maybe the bleeding port has not been blocked... You decide, intervening or open..."
The patient's husband hesitated for a long time, and finally thought that his wife loved to be beautiful and opened her abdomen... Never mind.
"Doctor, I choose to intervene!"
......
Interventional Section,
Again ushered in Lin Feng!
Doctors and nurses in the interventional department: ".............................."
I really haven't tried it, and I intervened twice in a row.
In 10 minutes, the imaging begins...
At this point,
The patient is still bleeding............
"Found it!!"
"I'm going, it's here!!"
All doctors, nurses, anesthesiologists... They all looked at the bleeding hole on the developing screen.
Impressive is:
"Pancreatic duct"!!
(Pancreas: Located near the duodenum, through a pancreatic duct, leading to the duodenum.) ）
The real murderer has been found!
Combined with that bean-sized stone,
This patient should be bleeding caused by stones in the pancreatic duct, explaining the long-term friction of the mucosa, resulting in the rupture of blood vessels, plus after blocking the pancreatic duct, pancreatic enzyme stasis in the pancreatic duct will digest its own tissue, causing blood vessel rupture, which is possible...
As for why the gastroscope, it was not found?
Maybe it had stopped bleeding at that time, so the gastroscopy did not find it ...
If the real culprit is found, then it is necessary to stop the bleeding immediately.
Bleeding from the pancreatic ducts, drugs to stop bleeding are ineffective.
So intervene to stop the bleeding.
It just so happens that it is now undergoing interventional surgery.
Lin Feng quickly replaced the catheter, and then slammed the embolic material into it to fill the bleeding hole.
Intervene to stop bleeding, end.
Withdrawal of the catheter guidewire ...
Press to stop the bleeding...
End of interventional surgery.
......
Soon, the patient was pushed back to the ICU...
After 1 hour,
The patient woke up...
During this time, there was no more blood...
The vital signs finally returned to normal, which also confirmed that the bleeding point was indeed the pancreatic duct.
The only problem is that the patient has a little side effect complication of the contrast agent, but it is difficult for the ICU.
"Thank you Dr. Lin..."
The patient's husband saw that his wife woke up, her vital signs were still so healthy, and excitedly took Lin Feng's hand to thank her.
Lin Feng smiled: "I also have to thank you for your trust in the doctor, and you chose the second interventional surgery..."
If the patient's husband chooses to open his abdomen...
Lin Feng, they have to pull their intestines for hours, check it one by one, and waste hours ...
......
......
At the same time,
3 km away...
A clinic,
Patient, Zhang Jianqiu, 45 years old,
At this time, he suspected acute gastroenteritis, and accompanied by his wife, he came to the community clinic.
This is the 15th hour of his diarrhea.
The cause was suspected of being the bottle of five-fold yogurt that was about to expire last night, and then there was a colic in his stomach behind, but the pain had already made him sweat beads.
Just keep having diarrhea.
Lash
Dilutation of the water sample.
It still hurts ~~
"Never buy this expiring yogurt next time!"
Old Zhang scolded weakly.
And then
A ten-hour life began.
In the end, his wife couldn't help it, so she dragged him to the hospital.
。