After 100 Days Of Sign-In, The First Operation Shocked The World

"Khan, call me Doctor Lin..."

"Dr. Lin, I have a troublesome patient on my side. I can't find the cause. Can you help me with my palm?"

Lin Feng will naturally not refuse.

"good……"

Leave the consultation room and go to the emergency room.

"Let's talk about it, what's the situation?" Lin Feng asked curiously.

"During the day, there was a patient, a 68-year-old woman with abdominal pain and low blood pressure, and she was sent to the emergency department..."

Low blood pressure is a danger signal, which means that the patient has been in shock, and it is decompensated shock, which is life-threatening at any time.

Because the blood perfusion of the whole body's organs must be reduced, there will be hypoxia everywhere.

(At this time, blood will give priority to the two most important organs, the brain and the heart, and other organs will start to reduce blood perfusion and begin to damage...)

30 seconds later,

Came to the ward.

On the hospital bed, a white-haired old lady was lying on the bed, sucking oxygen.

There is an ECG monitor on the table next to the bed.

·Blood pressure 90/50mmHg……

Lin Feng was surprised: "This blood pressure is okay..."

Wang Jiayi: "She has a history of 153 cases of hypertension for more than 10 years..."

Lin Feng nodded. If he considers that the patient has a history of hypertension, then this 90/50 blood pressure appears to be very low.

Then Dr. Wang Jiayi continued the introduction.

"The old lady nodded and said that it had been painful for a few days. She also tried injections and medicines, but the effect was not satisfactory..."

"When we sent to the emergency department, we began to rule out things that were not like acute appendicitis, kidney stones, renal colic, cholecystitis, pancreatitis, gastric perforation, etc... none of them..."

"Then the blood was drawn and the examination results came out. It was suspected that the patient was suffering from abdominal pain caused by diabetic ketoacidosis, because the patient had a history of type 2 diabetes, and when he was admitted to the hospital, the ketone bodies were high and there was also acidosis, so ketoacidosis can be considered... …"

"But... but after treatments such as blood sugar lowering and fluid rehydration, the abdominal pain did not get better..."

Then,

All the inspection results of Wang Jiayi will be shown to Lin Feng one by one.

Abdominal ultrasound, chest CT...

Blood routine, urine routine, electrolyte...

Kidney...

Lin Feng took a look at these materials.

There is nothing found on abdominal ultrasound, which can rule out appendicitis, cholecystitis, kidney stones, intestinal obstruction...

"One more thing, the patient's blood pressure is constantly falling..."

Wang Jiayi said cautiously.

Lin Feng pondered.

What is the reason for the low blood pressure and the constant drop?

Abdominal infection?

Septic shock?

Because of unknown reasons, it will be more troublesome. It is like a time bomb, which may explode at any time.

"Although I can't find the reason, I can treat it first with anti-shock, and use fluids and blood pressure drugs..."

"Well, it's already in use..."

Lin Feng continued to stare at the ECG monitor.

soon,

Lin Feng found something wrong.

"what……"

"Do you think this heart rate seems a little bit out of order?"

Lin Feng pointed to the ECG monitor and asked.

"Have it?"

"Yes... forget it, let me listen to him..."

In the emergency department, stethoscopes are often worn, and Lin Feng happens to have them.

The old lady is asleep at this time.

Lin Feng gently used the stethoscope to listen to the old lady's heart.

One minute……

Two minutes...

Lin Feng stretched his brows.

"The heart rhythm is indeed not uniform, it looks like atrial fibrillation...Push an electrocardiograph over and pull her an electrocardiogram..."

Ventricular fibrillation was written earlier.

(aicd) 　Ventricular fibrillation is the whole heart, like shaking pork, constantly shaking...

And atrial fibrillation is not the same as ventricular fibrillation, that is, a single house is trembling, irregular...

find the new land.

This is a problem that the doctors did not notice during the day.

If it is atrial fibrillation, there must be a big problem.

soon,

The electrocardiograph was pushed over.

Pull the electrocardiogram.

Soon, the results came out.

P wave disappears, baseline disappears, and the RR interval is absolutely different!

This is exactly the three basic characteristics of atrial fibrillation!

confirmed!

"It's atrial fibrillation!"

Lin Feng thinks of abdominal pain from atrial fibrillation...

Suddenly thought of an "answer!"

"Mesenteric artery embolism"! !

In atrial fibrillation, the blood flow in the atrium is irregular, which easily causes local thrombosis, which is usually attached to the atrium.

Once the thrombus falls off, it may flow to different organs along with the blood flow, causing corresponding embolism, such as cerebral infarction as written before...

It may also cause superior mesenteric artery embolism, limb arterial embolism, renal artery embolism...

Once embolized, what will happen?

Local tissue is ischemia, hypoxia, and then begins to die!

This disease is very dangerous!

so,

The old lady in front of me is probably "superior mesenteric artery embolism"!

Lin Feng informed the doctor Wang Jiayi of his guess.

"Huh? Superior mesenteric artery embolism?"

The Wang family was at a loss at first, and then became serious again.

Recalling the whole case process,

"It's really possible!"

"Yes, I think it's very likely... You go to communicate with your family. If you have this disease, you need to do an enhanced CT scan, otherwise it can't be diagnosed..."

"Okay, I'm going now... However, the radiography will damage the kidney to a certain extent, but the old lady is so old, I am afraid the kidney is not very good, there is a risk..."

"There is no way if there is a risk. To diagnose whether it is "superior mesenteric artery embolism," this imaging is necessary. If you are afraid of side effects, then it will not work, you can give the old lady a dialysis..." Lin Feng gave a suggestion.

Doctor Wang Jiayi pondered and nodded: "This idea can be..."

Next,

It is the communication between the family members.

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ps: End of today...

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