Afterwards, the group returned to their seats.

In the afternoon, a male patient with difficulty swallowing and black stool for more than a month came in.

His face was a little bad, very pale, and he looked like he was anemic.

However, his body is still quite big and strong.

The doctor on duty in the afternoon was Wu Jiang.

As soon as I heard that this patient had dysphagia and black stool, it was naturally related to the digestive tract, and it was most likely the upper gastrointestinal tract.

First of all, blood was drawn for examination, and it happened that the patient did not have breakfast to arrange a gastroscopy, and by the way, the doctor of the Department of Gastroenterology was notified for consultation.

There are also ECGs and chest x-rays to be done.

Dysphagia: If the patient is an older patient, esophageal cancer is the first consideration.

But the male patient in front of him was only in his early thirties.

You shouldn't get cancer, right?

Wu Jiang thought suspiciously, but it was hard to say if the final result did not come out.

Soon, a doctor from the gastrologist came over.

"What's the situation?"

Wu Jiang said to him:

"The male patient, 30 years old, had dysphagia and black stools for more than two months. It is said that no matter what you eat, you always feel that something is blocked in your throat, whether you eat liquid food or hard food. ”

The gastrologist frowned and immediately said:

"Progressive dysphagia? Be wary of esophageal cancer. ”

Wu Jiang also nodded, how could he not mean this.

Soon the patient's checklist came out.

The gastroscopy showed severe narrowing of the lumen, a mass in the lower esophagus, and slight bleeding.

Seeing this lump, the doctor in the Department of Gastroenterology shook his head and said, "I'm afraid it's really esophageal cancer, and it may still be in the middle and advanced stages." Are the ECG and blood routine results out? ”

"It's out, here."

ECG and blood routine are no problem, but the hemoglobin is low, only 90g/L (120-150g/L for men).

This man is really a little slightly anemic.

Chest x-ray shows pneumonia but is not severe.

Suddenly, there was a call from the gastroscopy department.

"Hello, Wu Jiang of the emergency department."

"yes, the patient was sent from the emergency department."

"Huh? Not finished? Okay, I got it. ”

After Wu Jiang hung up the phone, he explained to the doctor in the department of gastroenterology:

"When I did the gastroscopy just now, I didn't continue before I finished it, because the tumor on the patient's esophagus bleed at the slightest touch, and the bleeding was quite a lot, so they didn't dare to probe in it anymore, for fear of causing heavy bleeding."

The gastrologist nodded and said:

"Okay, I know, it seems that the preliminary diagnosis is esophageal cancer, and it is likely to be in the middle and advanced stages! Let's do a pathological classification to see what kind of cancer it is. ”

According to the results in the gastroscopy list, it is indeed very similar to esophageal cancer.

And the symptoms of the patient are also more obvious, plus he usually likes to drink strong tea and eat stimulating and spicy things.

In the long term, this irritates the wall of the esophagus, which is why it causes such a consequence.

Ay!

Typical diseases come from the mouth!

Wu Jiang went over to explain the situation to the patient.

As a result, the patient didn't believe it!

"Make no mistake, right? Am I so young for esophageal cancer? Or is it mid-to-late? ”

Not only did the patient not believe it, but he was also very angry.

Wu Jiang also understood the patient's mood and patiently explained:

"This is a checklist, you can see, the gastroscopy shows that there is a lump in the lower part of your esophagus, and there is bleeding.

This bleeding is the reason why you have been having black stools for the past two months.

Blood turns black when it is expelled after digestion in the stomach and intestines.

The lump on the esophageal paralysis is also the reason why you have had difficulty swallowing for the past two months. ”

The patient looked at Wu Jiang suspiciously, and then looked at the checklist in his hand.

After a few seconds he threw the checklist and yelled:

"Impossible! How could I get cancer at such a young age! ”

The voice was so loud that it even attracted the attention of other patients.

"Don't get excited, this is just a preliminary diagnosis, and you have to do pathological classification, don't get excited."

"Don't you get excited about all the cancer?! No way! I don't believe it! Lao Tzu is so young and has not even married yet, so he has cancer? I don't believe it! ”

The patient got up and got dressed as he spoke, damn, he didn't look at this broken disease!

Or go back to another hospital.

"Oh, why are you going? Your lump is very serious, and it is easy to bleed at the slightest touch, so you can't run around! ”

Wu Jiang chased after him, but this person didn't listen, and said as he walked:

"Damn, it's really strange, it's not a big deal if I don't come to the hospital, but when I come to the hospital, I actually say that I have cancer?"

Just at this time, Lin Yi came back from outside.

One didn't pay attention and bumped into the patient.

Lin Yi hurriedly said:

"I'm sorry, I didn't hit you, did I?"

The patient glared at Lin Yi without speaking, turned his head and left.

Immediately after that, Wu Jiang's shout came from behind him:

"Ouch, Lin Yi stopped this patient, he can't cure esophageal cancer, he has to go!"

"Esophageal cancer?"

"Yes, the lump on his esophagus is very large, and the stricture is also very serious, and the people in the gastroscopy room said that the lump bleeds when touched, and they don't dare to probe inside."

If this kind of patient is sent home, it is easy for something to happen.

If you go home and eat something that causes heavy bleeding, it won't be the end of the calf.

As a result, the two turned back to find someone, but they disappeared.

There are many people in the hospital, and people come and go, but this patient runs fast.

One turn and then disappear!

"What can I do, if I have a heavy hemorrhage at home, I'm afraid it won't be too late to save it!"

"Yes, if this patient is really allowed to go home, the consequences will be unimaginable!"

Lin Yi nodded and said, "Then look for it again, if you can't find it, forget it." ”

"Okay."

After speaking, Lin Yi and Wu Jiang searched at the emergency door and outside again, but they still didn't see anyone.

Forget it, since the patients themselves don't want to be treated, then they can't help it.

The doctor from the Department of Gastroenterology came to take a look, and he was also confused, why did the kung fu man disappear after a while?

"What's the situation? What about patients? ”

Wu Jiang sighed helplessly and said, "I ran away, saying that I didn't believe that I had cancer." ”

"Huh? This...... What if there is a massive hemorrhage along the way?! ”

"What else can I do? He's going to go himself, whatever. ”

Wu Jiang didn't bother to look for it after looking around and didn't see anyone, so let's put it badly.

At six o'clock in the afternoon, when Lin Yi had just changed his clothes after work, the ambulance sent a patient with stomach bleeding.

And it's the kind that vomits blood!

It happened that Wujiang was on duty at night, and the patient recognized it as soon as he came to Wujiang!

Isn't this the same patient who ran away with esophageal cancer in the afternoon?!

"Quickly test your blood type! Take the plasma first, and then let the blood bank adjust the blood as quickly as possible, plasma, red blood cells, and platelets! ”

Wu Jiang hurriedly ordered to go down.

He knew something was going to happen when the man ran away in the afternoon!

Look! What a problem!

In the afternoon, the platelet examination has already shown that it is mild to moderate anemia, and if I vomit like this now, I am afraid that I will have hemorrhagic shock in less than 20 minutes!

Wu Jiang looked around and asked:

"What about the family? Why didn't he see his family, he is so serious now that he wants his family to come over. ”

The emergency doctor also looked helpless:

"I don't know, it was his own emergency call, and he could still talk when we went, but he had vomited two pools of blood in the house.

I don't know what the cause is, but I suspect that it is a gastric varices or a gastric ulcer with massive bleeding? ”

Wu Jiang immediately denied:

"No, it's not gastric varices or stomach ulcers, it's esophageal cancer!

This man had a check-up in our hospital in the afternoon, but he didn't believe that he could get cancer at such a young age, so he ran home without treatment.

As a result, I didn't expect to be sent by ambulance now!

How much blood has he vomited since just now? ”

"If there is not a thousand, at least seven or eight hundred."

Wu Jiang's face was solemn after hearing this.

The blood has to come quickly, otherwise it will be too late to rescue the hemorrhagic shock!

That's when misfortune happened!

"Vomit...... ...... vomit"

"Oh no! The patient vomited blood again! The nurse exclaimed.

While talking, he hurriedly took a plastic bag to pick it up.

But this blood vomited very suddenly, and I couldn't catch it at all!

The entire pillow towel and sheets were instantly wet with blood!

"Vomit ......"

Still throwing up!

The patient is confused, so vomiting blood is an instinctive reaction.

The bright red blood shocked everyone to watch.

"Oh no! Blood pressure has also dropped suddenly! ”

Before any patient enters the rescue room, ECG monitoring, oxygen, and establishment of intravenous access are standard for rescue.

At this moment, the blood pressure on ECG monitoring has dropped from 84/60mmHg to 70/52mmHg!

"Oops! When this person was admitted to the hospital in the afternoon, his blood pressure was only 94/64mmHg! Now it's down to more than 70 again! Hurry up for a blood transfusion! ”

Wu Jiang's voice was not loud, but the seriousness of the matter was heard by everyone present.

Once the blood pressure drops any further, the person is gone!

Moreover, the clinical manifestations of night sweats and rapid breathing, which are close to shock, are becoming more and more severe.

But now the problem is that there is a tumor on the esophagus and it bleeds with a light poke.

In addition, there is no way to do a gastroscopy to check the situation when there is heavy bleeding now, and there is no way to reach into the stomach to stop the bleeding.

It can only be stabilized by blood transfusion.

"The blood hasn't come yet, it's for the plasma!"

"Hurry up!"

If there is no blood, the fluid that expands the blood volume can be infused first, and it can be relieved for a while.

"Call the gastrologist and tell them to come down and have a look."

"Okay!"

Lin Yi, who had just changed his clothes and came out to get off work, heard the movement in the rescue room.

Before I got closer, I smelled a strong smell of blood.

I couldn't resist being curious, Lin Yi went to the rescue room to take a look.

When even he was surprised, he asked, "Is this person the esophageal cancer patient you said in the afternoon?" ”

Wu Jiang looked anxious: "Yes, I'll just ask him not to run around, look, he was sent to the hospital by ambulance in just a few hours." ”

Looking at the blood stains on the entire bed and floor, Lin Yi knew that this person should have completely broken the tumor blood vessels on the esophageal wall.

As a result, when Lin Yi's eyes looked at the patient's esophagus and stomach, he immediately frowned!

Well?

Isn't this esophageal cancer?!

This...... It's not esophageal cancer at all!

Drip, drip!

Suddenly, the ECG monitor rang again!

This time, not only is the patient's blood pressure dropping, but his heart rate is also gradually starting to drop!

Even the ECG ripples are starting to level off to the point where you can't see the ups and downs!

"It's over! It's cardiac arrest! Adrenaline 1 mg intravenous push, lobeline a intravenous push! ”

Wu Jiang instructed while standing on the side of the bed and doing heart compressions.

"Good!"

"Wait!" Lin Yi hurriedly grabbed Wu Jiang: "Don't do heart compressions!" ”

Everyone turned their heads and looked at Lin Yi suspiciously.

"Why don't you do cardiac compressions? This man's heart is almost gone! ”

Wu Jiang didn't understand what Lin Yi meant.

Shouldn't CPR be done in cardiac arrest?

"His bleeding point is in the lower esophagus, right, it's right near the heart, if you press it again, it won't bleed even more?!"

Wu Jiang was stunned.

Oh, yes......

This way you will die faster......

"That'...... So what to do? Wait for him to die? ”

Wu Jiang is out of line.

Thankfully, the blood came at this time!

"Blood is coming, blood is coming!"

The nurse from the blood bank hurriedly sent red blood cells, plasma, and platelets, a total of 600 milliliters.

"Hurry up and enter it, and what about his morning checklist, what tests have been done? How is esophageal cancer diagnosed? ”

After Lin Yi appeared, the command of the scene was unknowingly handed over to Lin Yi.

"Chest X-ray, electrocardiogram, gastroscopy, and blood routine were all done."

Wu Jiang took the examination sheet that the patient had thrown away in the morning.

Lin Yi looked at the checklist and asked Wu Jiang to directly use the pressurizer to squeeze fresh blood into the patient.

In the infusion tube, the blood was still flowing at a drop rate, but under Wu Jiang's vigorous squeezing, it directly became a straight line, constantly entering the patient's body.

Although the blood was a little colder, the nurses next to him were covering their hands with their hands to keep the temperature of the blood as cold as possible.

Fortunately, six hundred milliliters of blood were useful.

After the infusion, the patient's blood rebounded, the effect of the drug also took effect, and the blood pressure also rose.

Wu Jiang saw that Lin Yi had been staring at the checklist, and asked:

"Lin Yi, here...... What's famous? Could it be that this person is not esophageal cancer? But the lump and bleeding on the gastroscope are very clear. ”

Of course, Lin Yi knew that the gastroscopy results showed that there was indeed a mass in the esophagus.

But the problem is that the cause of this person is under the lump!

He's not esophageal cancer at all!

But......

However, the doctor in the gastroscopy room did not continue to explore because he was worried that the lump would cause heavy bleeding.

This problem was not discovered, which caused a misdiagnosis.

After looking at it for a while, and seeing that the patient's condition was stable again, Lin Yi hurriedly ordered:

"Let the blood bank transfer 600 milliliters of platelets and plasma, and then send the person to the operating room quickly."

"Huh? This...... How do you send this to the operating room? Is direct surgery to stop the bleeding? But...... But how can this situation stop the bleeding? ”

Lin Yi glanced at Wu Jiang and said:

"I have a way."

This............

Wu Jiang couldn't help but be stunned.

Okay, I'm overthinking!

As soon as the gastrologist came down, he saw the emergency department taking the patient to the operating room.

"Alas, why did you send people away before we saw it?"

The nurse in the emergency department replied:

"Dr. Lin is here! He told us to take the patient to the operating room. ”

Gastrologist: "Say it earlier, let's go for nothing." ”

in the operating room.

Six hundred milliliters of blood arrived.

Surgery while transfusing blood is a very dangerous act.

But Lin Yi still withstood the pressure.

The gastroscopist next to him felt a little empty.

"Doctor Lin, can you still go to the operating room if this vomiting blood is so serious?"

(End of chapter)