Wu Jiang comforted:

"Don't worry, let's go for a colonoscopy first and see what the problem is."

The family members didn't understand, so they could only nod and listen to the doctor.

Soon the unlucky young man was sent to the colonoscopy room again.

This colonoscopy was more careful and longer than the last time.

Wu Jiang stared at the screen for a moment, for fear of missing something.

Suddenly, a strange protruding malformed blood vessel was found in the location of the sigmoid colon?

And there is a small bleeding spot on this malformed blood vessel??

"Huh?! Didn't you last time here? How can a vascular malformation suddenly appear? Did we not see it last time?"

Wu Jiang asked the doctor who was doing the colonoscopy next to him to observe the colonoscopy back and forth repeatedly.

In this position, Wu Jiang remembered that there was indeed no deformity before.

What's going on?

Wu Jiang couldn't help but look confused.

After the colonoscopy, Wu Jiang sent the examination list to the doctor of anorectal surgery.

It happened that Zhou Chao was also in the office at this time, and Wu Jiang told Zhou Chao about it.

Zhou Chao was also puzzled after hearing this:

"Two bleeding from one hemorrhoid surgery? And there was no malformation in the colonoscopy last time, but there was a vascular malformation this time?

What you mean is that the last bleeding may have been caused by the patient straining too their own stool.

Is this bleeding caused by a malformation of the blood vessels?"

Wu Jiang nodded:

"That's right, this vascular malformation has a bleeding point, and I guess this time it must be a problem with this vascular malformation."

Zhou Chao nodded and said:

"Then this young man has to get the vascular malformation solved quickly, or he will have to bleed again."

It just so happened that the anorectal surgery department also came with news, saying that the vascular malformation should be removed immediately, otherwise the amount of bleeding may increase the risk.

When the patients and their families heard this, they were both confused and frightened.

"Why did I come to the hospital to cut hemorrhoids, how could so many things happen? Not to mention the bleeding, this time I was found to have a vascular malformation??"

The patient wanted to cry aggrievedly.

What is this called?

And to listen to the doctor's surgical plan, you must also cut a small part of the intestine.

Because the malformation of the blood vessel attached to the intestinal wall cannot be removed alone, it can only be cut off together with the section of the intestine to stop the bleeding and prevent bleeding.

If the deformity is excised alone, it is easy to cause heavy bleeding.

This guy, a small hemorrhoid surgery turned into a major surgery that required an open stomach to remove the intestines in the blink of an eye.

The patient finally couldn't help but erupt.

Standing at the door of the emergency office with the pain from his asshole, he scolded Wu Jiang for more than half an hour before he was relieved.

As a result, as soon as I returned to the ward, I began to pull blood again.

Visually, the amount of bleeding this time is about 100 milliliters.

Seeing that the situation was not right, the family members hurriedly ran to call the doctor again.

Wu Jiang and Zhou Chao hurriedly came to the ward to check the situation.

Looking at the blood in this urinal, Zhou Chao also knew that the operation could not be delayed.

At this rate of bleeding, sooner or later the patient will develop anemia and severe shock.

Zhou Chao immediately turned around and called the anorectal surgeon, saying that the patient was bleeding again. They went straight to the emergency department for emergency surgery.

Zhou Chao personally took charge of the knife.

As soon as the patient heard that Zhou Chao was going to do this operation by himself, then he had nothing to worry about.

After all, it's the emergency director.

How can you be a director in two moments?

Preoperative infusion, anticoagulation and expansion, and blood draw to check hemoglobin by the way.

116g/L。

Fortunately, although about 300 milliliters of blood came out, the patient has not developed anemia so far.

The family also signed to agree to the operation, and the patient was soon taken to the operating room.

The surgery is performed laparoscopically.

A hole is made around the umbilicus, the lens is inserted into the abdominal cavity, and the location of the vascular malformation is accurately found with the colonoscopy.

In order to ensure accuracy, Zhou Chao also stretched out his index finger and touched it.

There is indeed a feeling of a lump in the place of the vascular malformation.

After confirming the position, Zhou Chao went down with a knife and cut off the intestine about three centimeters around the vascular malformation.

After the cut, the bowel tube is re-anastomosed.

The operation was performed by the chief emergency officer, which not only reassured the other doctors, but also comforted the family.

The surgery was a success.

The vascular malformation was cut out and shown to the family.

There is indeed a protruding cyan vein, which looks strange and terrifying.

"Thank you, doctor."

The family members were very polite and thanked Zhou Chao.

Zhou Chao waved his hand and said:

"Many patients have complex conditions, and sometimes the disease is dangerous, and we doctors only have a pair of eyes, and it is impossible to cover everything."

………………

The Department of Cardiac Surgery received a patient, a 73-year-old woman with a heart disease.

Sudden shortness of breath for an hour, cardiac arrest once, and he was rushed to the hospital.

Shortness of breath is unable to lie flat, can only sit upright to breathe, and coughs up pink frothy sputum.

When I was admitted to the hospital, I noticed that my heartbeat, breathing, and pulse had stopped.

Immediately give cardiopulmonary resuscitation, intravenous epinephrine, and a series of rescue measures such as electric defibrillation and ventilator assisted breathing.

After about fifteen minutes, the patient regains a spontaneous heartbeat.

But consciousness is still in a blur.

Post-rescue physical examination, T36.7, P114 times/min, R15 times/min, BP88/58hg.

The pupils are large and round, but the light reflex is diminished, the breath sounds in both lungs are coarse, and crackles are heard.

The heart rhythm is in unison, and a systolic eruption murmur may be heard at the apex.

There was no edema in both lower extremities.

Past medical history includes diabetes mellitus and hypertension.

Routine blood cells: 17.31x10?? /L（4-10x10?? /L）

Neutrophil percentage: 44.2% (50-70)

Blood glucose: 25.4ol/L.

Hypersensitive troponin T: >5000pg/.

(One of the markers of myocardial injury.) ）

Creatine kinase: 213 U/L (0-25)

The rest of the liver function, kidney function, thyroid function, and blood lipids were not abnormal.

ECG: QRS complex high voltage.

Coronary angiography showed that there was no stenosis in the left main trunk and anterior descending artery, and no stenosis in the right corona.

Cardiac ultrasound: the ventricular septum is thickened in the left ventricular wall, with a thickness of 38 (20-35) and decreased compliance.

When all the test results came out, Wang Zhongliang immediately gave a diagnosis:

1. Fulminant myocarditis 2, acute pulmonary edema 3, acute left heart failure 4, coronary obstructive myocardial infarction?

Fulminant myocarditis does cause thickening of the ventricular wall, so Wang Zhongliang, deputy director of cardiac surgery, considered this as the primary diagnosis.

As for coronary obstructive myocardial infarction, there is a question mark behind it, which requires further observation to determine.

However, the patient's hypersensitivity troponin and creatine kinase are very high, so the possibility of myocardial infarction cannot be ruled out.

After the diagnosis, Wang Zhongliang also told his family.

The patient's cause is wall hypertrophy due to myocarditis.

Hypertrophy of the wall reduces the heart's ability to contract.

If the systolic function is reduced, the blood outflow from the left ventricle will decrease, and all the blood will be piled up in the ventricle and cannot be discharged.

It can cause both heart failure and increased pressure in the pulmonary veins.

So left heart failure and pulmonary edema appear together.

After the rescue was over, Wang Zhongliang also issued a long-term medical order for infusion.

First, the blood vessels are dilated, increasing cardiac output.

Then increase the contractility of the heart muscle, dopamine.

(The dosage of dopamine should be strictly controlled, and the effect of different dosages is different.) ）

Nitroprusside, which lowers arterial pressure and reduces left ventricular outflow tract afterload.

As a result, two days after taking the drug.

The old lady showed no signs of getting better.

And there are also aggravated cases!

The family will definitely not want to.

"Can't you cure a disease in such a big hospital?!"

"One heart failure and pulmonary edema, I think other people with the same disease can be discharged!"

"Is our family getting worse and worse? Is this the level of medical care you have?! Or are you deliberately discriminating?!"

"Are we bullying us because we came from out of town?!"

The family said that the face was red and the neck was thick.

Today is the third day of hospitalization.

The patient's condition did not decrease but increased, and Wang Zhongliang also overturned the previous diagnosis after the morning round.

It is common sense that the situation will be much relieved after taking the medication.

But the old lady got worse.

So this medicine can no longer be used.

Discontinue the drug first.

In the morning, the patient did not take any medication and did not give the latest diagnosis.

Naturally, the emotions of the families reached a flashpoint.

She yelled as she walked towards the doctor's office.

Wang Zhongliang heard this commotion and immediately walked out of it.

"Family, please stay calm, we are currently discussing the true cause of your mother's illness, and we will inform you when the results are available."

The family members are clearly not buying it.

"Notice?! When's the notice?! Will you notify them after everyone has lost their breath?"

"Don't get excited, we didn't deliberately bully you, don't worry, we will stabilize your mother's current situation, and there will be no danger to your life for the time being."

"I want a concrete result!" The family roared.

"I'll let you know as soon as we're done."

Wang Zhongliang said patiently.

In hospitals, it is common for family members to become emotional because of the patient's condition.

Some doctors have a good temper and try to explain.

When you meet someone with a bad temper, you will quarrel directly.

Fortunately, Wang Zhongliang's temper is good.

In fact, there are many diseases whose cause cannot be found, and doctors can only continue to learn and move forward in the process of exploration.

Suddenly, as soon as he finished speaking, several other family members in the custody room suddenly rushed out and said:

"Doctor! Come and see, why did your blood pressure drop all of a sudden?!"

In the doctor's office and the nurse's office, as soon as they heard that their blood pressure had dropped, they came to the intensive care unit one after another.

It was originally a heart failure patient, but now the drug effect is not good, and one may die if he is not careful.

Vital signs can only be detected at any time.

"Director Wang, stop beating!"

"Hurry up CPR, adrenaline one milligram intravenous push!"

"Get on a ventilator!"

"Lobelin pushes quietly!"

"Lidocaine 50 mg intravenously!"

The intensive care room became an emergency room in an instant.

People with heart failure who can't find a cause are at risk.

The family can only pray silently at the door:

"You must succeed in the rescue...... Please!"

Finally, thirteen minutes later, the patient's spontaneous heartbeat was restored.

The doctors and nurses who rescued them breathed a sigh of relief, as did the family members outside the door.

But that doesn't solve the urgent need at all.

The patient's problem with heart failure is that the heart muscle is weak due to ventricular hypertrophy.

However, after taking drugs that increase the contractility of the heart muscle, the situation worsened instead of getting better!

"What should I do? Director Wang!"

A doctor next to him frowned and asked Wang Zhongliang.

"I think of a ...... person."

Wang Zhongliang stared ahead and said.

"Who?"

"Lin Yi in the independent clinic of the emergency department!"

After speaking, he directly took out his mobile phone and called Lin Yi.

"Hey? Dr. Lin, yes, our department admitted a patient with a thickened left ventricular wall with acute left heart failure and pulmonary edema.

However, after I finished using the medicine, there was still no improvement in the slightest, but the patient's condition worsened.

So I'm trying to get you to help take a look, do you think you have time?"

Lin Yi thought for a while and asked:

"How is the patient doing?"

"It's not good, I did another cardiopulmonary resuscitation just now to rescue people, and I was really anxious so I bothered you."

"What drugs were used in the previous treatment?"

Wang Zhongliang's 1510 answer:

"Dopamine, dose and drip rate is 2-5ug/kgn, which is pumped. There is also sodium nitroprusside, 25 μg/n, nitroglycerin, 10 μg/n, and some basic nutrients."

Hearing Wang Zhongliang's answer, Lin Yi also frowned.

There is nothing wrong with these drugs, they are indeed drugs that are needed in heart failure, such as dilating blood vessels, increasing myocardial contractility, and reducing the load on the outflow tract.

No problem.

But Wang Zhongliang said that the patient not only did not get better, but worsened, and also performed a cardiopulmonary resuscitation?

Lin Yi did not make a rash conclusion, but said:

"I can't give you an accurate answer just by hearing you say it, so I'll come and help you see the specific situation of this patient."

Hearing Lin Yi's answer, a smile instantly appeared on Wang Zhongliang's face.

"That's great! Thank you, Dr. Lin!"

hung up the phone, Wang Zhongliang's tightly frowning brows finally relaxed.

After Wang Zhongliang returned the mobile phone to him, he hurriedly walked to the side of the family and said:

"I've contacted a doctor with great strength and insight to come and help you consult, and he'll be right away."

The family member who yelled just now shook his hand and glared at Wang Zhongliang and said:

"I don't care what kind of doctor or expert you are, if you can't cure my mother, I'll complain to you right away!"

Other family members on the side hurriedly reassured her:

"Huahua, don't say that, my mother is old, and there is nothing she can do if she has this disease."

"Huh? What can't be helped? I see that the other beds can get better and be discharged, why can't my mother?"

The family's emotions have not calmed down, and Wang Zhongliang did not say anything more to her.

I'll know when Lin Yi comes over and sees.

"Dr. Lin, you're here!"

Behind Wang Zhongliang, there were several other cardiac surgeons, staring at Lin Yi tightly.

"It's not hard, it's important to save people, take me to see the patient first, right?"

"Okay, you come with me."

After the words fell, Wang Zhongliang hurriedly took Lin Yi into the intensive care unit of the cardiac surgery.

There were five more serious patients lying in the intensive care unit.

It's all heart problems.

Wang Zhongliang brought Lin Yi to the old lady.

Subsequently, he carefully introduced Lin Yi's condition, and handed the patient's checklist to Lin Yi to see.

At this moment, Lin Yi was staring closely at the patient's heart.

After a while, Lin Yi's expression gradually became solemn!

"Reasoning and Diagnosis: Big Brother, Your Wife Is Drugged!" In order for you to see the fastest update of this book next time, please be sure to save your bookmarks!

Chapter 277: The Old Lady with a Stopped Heartbeat! Free to read.