Chapter 1557

"Doctor, is my lover seriously ill?" In the emergency room, a middle-aged woman followed the physician out.

Zheng Ren was stunned and heard someone talking in his ear.

"Heavy!" The physician said definitely, "there is bleeding in the digestive tract. There is a faucet whirring blood. Do you think it's heavy?"

The emergency physician said, looked up and saw Zheng Ren and said, "President Zheng, is the director okay?"

"Nothing." Zheng Ren smiled, "what patient?"

"Nausea, vomiting, low blood pressure, considering upper gastrointestinal bleeding, ready to be admitted to the hospital."

This situation is common. Tips surgery is aimed at patients with portal hypertension, as well as ulcer, rupture and bleeding of gastric fundus and intestinal mucosa.

If it were not for portal hypertension with varicose gastric fundus veins, the cirrhotic hematemesis would not be very large. Generally, the bleeding arteries would not be very large. They would be hospitalized for gastrointestinal decompression, static hemostatic drugs, and then oral Zhengshen ice saline for 2-3 days.

"What's the blood pressure?" Zheng Ren asked casually.

“75/50mmhG。” The emergency physician took the patient's family members to open the hospitalization form, leaving Zheng Ren with a data.

Fortunately, although it is shock, the blood pressure is not particularly low.

Zheng Ren looked at the probe. There was a middle-aged man lying on the bed in the emergency room, his face was pale, and the value displayed by ECG monitoring

Why is oxygen saturation so low? There are also some problems with the waveform of ECG.

Zheng Ren felt wrong and took a look at the door.

The system panel is red and frightening, and the diagnosis seems to be bleeding - massive pericardial effusion and aortic adventitia ulcer.

Uh... What's the disease?

Zheng Ren knows that the doctor in the emergency department made a wrong diagnosis. As for why he made this mistake, he didn't think about it for the time being.

He immediately opened a drawer of the console, which contained a mercury sphygmomanometer and a stethoscope.

Picked up the stethoscope, Zheng Ren began to auscultate the patient.

A large number of wet rales can be heard in both lungs, and the heart sound is low and far away. There is no doubt that it is a heart sound filled with pericardium.

Because he was a man, Zheng Ren didn't check whether he had the "Yirong" patient he met last time.

Pericardial tamponade is also divided into acute and chronic. If it is traumatic, the heart breaks a big hole, and the blood cannot go out. It is piled in the pericardial cavity, which belongs to acute pericardial tamponade.

If the cardiac function is not complete and the renal function is not complete, it may lead to the disorder of fluid circulation and chronic pericardial tamponade.

Pericardial effusion and even pericardial tamponade are understandable. But what the hell is the diagnosis of aortic adventitia ulcer? How did you get here?

There will also be ulcers in the aorta. This situation refers to the rupture of atherosclerotic plaques in the intima of the aorta to form ulcers, which penetrate the inner elastic layer.

However, the big pig hoof gives an aortic adventitia ulcer.

Inflammation? Or something?

Just thinking, the emergency physician came out after writing the hospitalization form for hospitalization in the Department of Gastroenterology, greeted the accompanying examination and sent the patient to the hospital.

When she saw Zheng Ren checking his body in front of the bed, she asked, "President Zheng, what's the matter?"

"Don't rush to be hospitalized, open a lung CT." Zheng Ren said, "what is the medical history?"

The emergency physician was stunned. It was clear that there was bleeding in the upper gastrointestinal tract. Why didn't president Zheng let him enter the hospital and open a lung CT examination?

"Male patient, 42 years old, came to our hospital for treatment for 3 hours due to repeated nausea, vomiting and dyspnea." Despite doubts, emergency physicians routinely report medical history.

The obscenity of the superior doctor is no joke. It has long been used to nature.

"The patient suddenly had dyspnea 3 hours ago, slightly felt chest tightness, accompanied by nausea and vomiting for many times, each time with a small amount of gastric contents and a small amount of coffee, no abdominal pain, which has nothing to do with eating posture. There was fecal incontinence, and the stool was yellow dilute stool."

"Nausea and vomiting? Coffee?" Zheng Ren asked.

"Well, occult blood is positive. It is considered to be caused by upper gastrointestinal bleeding. Because there is no hematemesis, the bleeding should not be very serious." The emergency physician said.

Zheng Ren pondered.

Things are very wrong.

According to the medical history, the diagnosis of the emergency physician is correct.

Nausea, vomiting, spit out things for examination, there is positive occult blood, inferring upper gastrointestinal bleeding. All this is logical and there is no problem.

But why do you have difficulty breathing?

Seeing Zheng Ren looking at the patient in a daze, the emergency physician whispered, "President Zheng, hurry up and send it to the gastroenterology department. If the bleeding can't stop, you have to rescue something."

Emergency department? After diagnosis, send it wherever you should.

They were all rescued in the emergency department, and they were too busy.

A dozen or dozens of emergency patients were piled outside. When they met a bad tempered and urgent patient, they really opened their mouth and cursed.

Even being beaten is not uncommon.

It's not without a slap in the face.

Zheng Ren shook his head and said, "go and have a lung CT. I'll take the patient for examination."

The emergency physician didn't know why Zheng Ren insisted, and she didn't hesitate. The superior doctor said it and put forward his own opinions. He didn't listen. Then follow the superior doctor's orders first.

When the sky falls, there is a superior doctor. What are you afraid of.

"What patient, boss." Su Yun finished dealing with the female student and returned to Zheng Ren.

"It's strange. Listen." Zheng Ren gives Su Yun the stethoscope.

"Huh? Strange?"

"According to the medical history, the patient was diagnosed as upper gastrointestinal bleeding. There is no doubt. But there are problems with both lungs and pericardium during auscultation. I'm going to take the patient for CT first."

Su Yun took the stethoscope suspiciously and began auscultation.

In less than a minute, he looked up solemnly and said, "there's a problem. Hurry to check it."

With that, Su Yun asked, "upper gastrointestinal bleeding?"

"Nausea, vomiting, vomit occult blood test positive."

"Mr. Zheng, the CT list is finished. Will you take it with you?" The emergency physician asked.

"Yes."

The patient's family members are a little confused. They just said to send them to the Department of Gastroenterology for hospitalization. The doctor also described the condition very seriously. They may die a little later. Why do you have to check now?

"Doctor, what's going on?" The patient's family members asked with some anxiety.

"Have you been injured recently?" Zheng Ren didn't explain either. While carrying the patient onto the flat car with the inspector, he asked.

"Recently? No." The patient's family said: "I was injured a few years ago, clavicular fracture and had an operation. Nothing has happened recently. It's very normal."

Zheng Ren glanced. There was an old surgical scar in the patient's left sternum, which was a long time ago.

Strange, no trauma, where did aortic adventitia ulcer come from?

According to the diagnosis of big pig hoof, Zheng Ren began to think about it.

But no matter what you think, it's a dead end and there's no idea at all.

Zheng Renhe and Su Yun trotted all the way in a flat car and accompanied the examination to send the patient to the CT room.

It was not until the patient went to the clinic and began CT that he relaxed his breath.