Lin Yi wrote down the chief complaint on the outpatient medical record.

"Chest pain on the left side for half an hour."

The woman is so young, and the part she is covering is the left midline of the armpit, not the chest.

In this case, heart disease is less likely.

"Is she hurt?"

"No, no, just about half an hour ago."

"My wife coughed twice without warning, and then suddenly she had pain in her left chest, and it was so severe that she didn't dare to move."

The man immediately said to Lin Yi.

Lin Yi frowned slightly after hearing this.

After coughing, he developed left-sided chest pain and no history of trauma.

Is it a spontaneous pneumothorax?

Some patients, if they have lung disease, especially those with bullae, may cough up the bullae after severe coughing, and spontaneous pneumothorax may occur.

Severe chest pain may also occur, but it is often accompanied by chest tightness.

"Do you have any stuffiness now, except for the pain in your left chest?"

Lin Yi stood up and came to the patient to give her a physical examination.

"Doctor, I don't have chest tightness, I just hurt, it hurts a lot."

The woman finally spoke, but there was a feeling of being out of breath.

Lin Yi knew that her situation was not caused by chest tightness, but because her chest hurt so badly that she didn't dare to speak continuously.

After examining her chest, it was found that at the midline of the axillary of the fifth rib on the left side, the woman refused to press and felt terrible pain when she touched it.

Lin Yi already had a judgment on the woman's condition in his heart.

I went back to the computer, wrote down the outpatient medical records briefly, and opened the checklist.

"I suspect you have broken ribs, go get a CT scan."

Her husband was a little surprised when he heard this, and then asked in disbelief:

"Doctor, my wife just has a cold and inflammation for the past ten days, and we have been infused in the small clinic downstairs for more than ten days, and now it is slowly getting better."

"She coughed even worse a while ago, and it was only after two coughs today that she had chest pain."

"She's not injured, how can she have broken ribs?"

"Otherwise, you can prescribe some painkillers, I think it's still an inflammation problem, let's continue to go back to the small clinic for infusion."

Lin Yi looked at the woman's emaciated figure and asked her:

"Are you so thin, are you born thin, or is it due to weight loss?"

Speaking of this topic, the man's emotions suddenly became a little excited:

"Doctor, I was angry when you said this, my wife's height of one meter six and five has always weighed more than one hundred and ten pounds before, but in fact, this body shape is just right."

"As a result, in the past two years, she didn't know where to listen to weight loss home remedies, and she didn't eat much every day, only a few bites of each meal, so she was anxious to let her eat more."

"As a result, in the past year, I have lost weight like this, and I only weigh more than 90 pounds."

"I think ah, her cold is a decrease in her resistance to weight loss, if it is the same as before, it will not be to the point of infusion."

Lin Yi nodded and said:

"You're right, it's excessive weight loss, which causes weight loss and reduced immunity."

"You look at her upper body, there's almost no fat. To put it mildly, it's almost like ribs. ”

"Her bone quality has also been greatly affected, and this cold, she has been coughing violently for more than ten days, and she coughed twice half an hour ago, which is a trigger for fractures."

"Generally speaking, at your young age, the likelihood of a fracture from coughing is extremely low."

"Usually, it is the elderly who have osteoporosis, and after a violent cough, there will be fractures."

"But you now have localized tenderness on your left side, and the pain is severe, so you can't rule out a rib fracture."

"It's best to take a CT scan to give you a clear diagnosis and symptomatic treatment."

"If you don't have a clear examination, simply prescribing painkillers to you is a violation of the principle and will not solve the problem."

Hearing Lin Yi's explanation in such detail, the woman thought about you and said hesitantly:

"Then I'd better go check it out."

Half an hour later, the man slowly moved into the consultation room with the woman in his arms.

handed the piece in his hand to Lin Yi.

Man says:

"Doctor, look at the results of my wife's examination, is it a fracture?"

Lin Yi took the CT film, put it on the viewing lamp, looked at it carefully for a while, and then pointed to a part of the film and said to the woman:

"See? This is the midaxillary line of the fifth rib, and the rib cortex is discontinuous, which is a sign of fracture. ”

"Your current severe left chest pain is a broken rib caused by coughing, you may never have heard of how coughing can cause rib fractures, but now it is happening to you."

Lin Yi glanced at her husband and continued:

"It stands to reason that a few coughs at your age can cause a fracture, which is almost impossible."

"The specific reason, I have already explained to you just now, is because you are too thin, your resistance is weak, and excessive weight loss is a trigger."

"It is recommended that you eat normally in the future and do not deliberately diet to achieve the goal of losing weight.

"If you only rely on dieting to lose weight, you may lose weight temporarily, but the harm to your body is much greater than the few pounds of meat you lose."

The woman did not speak.

She has now apparently realized the downsides of dieting to lose weight.

After all, before she deliberately dieted to lose weight, she was plump and not fat.

Before that, I didn't know what a cough and cold were.

But since I went on a diet to lose weight a year ago, I feel weak, occasionally dizzy, and have poor spirits.

And you get a cold and cough at every turn.

And this time the cold was even worse, and I was directly infused at the community health service station for more than ten days, but it was not completely well.

What's even more terrifying is that because of weight loss, I coughed twice and broke my ribs, which is really incredible!

It also completely scared her.

The woman decided that she would eat and drink heavily in the future, and resolutely stopped mentioning dieting and weight loss.

After all, life is still important!

Seeing his wife, it was really a broken rib, and the man was a little nervous.

"Doctor, hurry up and go through the hospitalization procedures for us and do surgery, she is in pain now, and her life is affected."

Lin Yi waved his hand and denied:

"Your lover only has a broken rib, and there is no misalignment, no hemothorax, pneumothorax, no need to be hospitalized."

"You only need to recuperate at home, and it is recommended to take a leave of absence for more than a month to rest, and wait for the fracture to grow slowly.

"I'll prescribe a chest strap for her, wrapping her chest will reduce the pain, and then prescribe some painkillers, take it when the pain is severe, and reduce the symptoms."