In the end, the woman still took the note, and it is unknown whether she called it or not.

Everyone has their own life, whether to rewrite or continue, and others can't help you decide.

September passed quickly, and the weather was getting cooler.

Li Xiyang had just finished clocking in the night shift, and the little nurse in the ward ran over in a hurry.

"Doctor Li, Doctor Li, the patient in bed 11 suddenly fell into a coma, you can go over and take a look!"

"Bed 11?"

"Dr. Sheng's patient?"

"Hmm!" The little nurse in the ward nodded her head and said quickly, "But Dr. Sheng has just gotten off work!" ”

"Let's go, take me to see it!"

On the way, Li Xiyang took the case handed by the little nurse and quickly swept his gaze.

The patient, a 32-year-old female, began to feel vague pain in the right abdomen 2 hours after dinner on the 7th, without radiating pain, accompanied by nausea and vomiting, which was partially relieved after vomiting out the stomach contents.

no bloating, diarrhoea, tenesmus,

Unconscious, no chills, fever.

During menstruation, uncertain about blood in the urine,

Poor appetite and poor sleep.

The outpatient clinic is admitted as "acute cholecystitis".

After a comprehensive examination after admission, B-ultrasound showed that there were 45 small calculi in the right kidney, 388 tubular structures in the right lower abdomen, and no abnormalities in thoracic and abdominal dialysis and electrocardiogram.

Finally, it was diagnosed as "kidney stones".

Kidney stones...

Li Xiyang closed the case and quickly came to bed No. 11.

The woman on the bed was already unconscious, and what surprised Li Xiyang the most was that the woman had a thin face and looked malnourished.

Fast!

Physical examination!

Body temperature 38.7,

pulse 110/n,

Respiration 20/n,

Blood pressure 90/60Hg.

The patient's right abdominal muscle is tense, and the McCere's point is more pronounced.

Percussion showed tympanum, negative moving dullness, and bowel sounds 5 times/n.

Li Xiyang shook his head, "No, this is not kidney stones, it is acute appendicitis!" ”

"Appendicitis?"

Chen Xu followed from behind, puzzled, "Shouldn't appendicitis faint?" ”

Appendicitis is a common disease in general surgery, and shock is very rare.

Li Xiyang shook his head, rare does not mean that there is none.

There are two common causes of shock in patients with appendicitis, one is that the pressure of the appendix lumen increases due to appendiceal fecal stones, which causes appendiceal ischemia and necrosis, and bacterial toxins spread through the portal venous system and retroperitoneal hematogen, resulting in systemic infectious shock.

The second is that endotoxins promote the release of inflammatory mediators such as histamine, kinin, and lysosomal enzymes, causing systemic inflammation, circulatory disorders, and finally shock.

Chen Xu asked, "Then what do you mean?" ”

Li Xiyang didn't answer directly, but turned to the little nurse on the side, "Show me the B ultrasound!" ”

"Oooh!"

The little nurse hurriedly found the patient's B-ultrasound and handed it over.

Taking over the B dynasty, Li Xiyang pointed to a very small shadow on the patient's right kidney and said, "The patient's right kidney has percussion pain, which looks like it is caused by this stone." ”

Chen Xu took a closer look, "Isn't it?" ”

Li Xiyang shook his head, "A 45 stone will not cause such a big reaction from a patient at all, let alone shock." ”

Chen Xu nodded, the thickness of the normal ureter is about 2-5, and the peristalsis of the ureter is strong, so usually urinary stones below 6 can be excreted through drinking water and exercise.

5 kidney stones do not make the patient faint in pain.

"Then what do you think is the reason for the patient?"

Li Xiyang frowned slightly and said, "Acute subhepatic appendicitis, septic shock!" ”

"What?"

Chen Xu's eyes widened, and he exclaimed, "You mean high appendicitis!"

”

Li Xiyang nodded and said to the little nurse, "Go and notify the patient's family to sign." ”

"Chen Xu, push the patient to the operating room!"

"Oooh!"

If it is really high appendicitis, the patient is dangerous.

Chen Xu didn't dare to delay at all, quickly lifted the patient to the gurney, and ran away from the operating room.

After the two left, Li Xiyang called Mo Kai.

Roughly explaining the situation, Mo Kai's voice was a little annoyed, "Why is this Sheng Lei again, it's been the first time this month!" ”

"Back to the misdiagnosis, doesn't this special mother want to do it?"

Li Xiyang didn't answer.

This kind of thing, it's better for him to talk less.

Mo Kai paused and asked, "Are you sure?" ”

Li Xiyang said, "I'm not sure, but you can try!" ”

Septic shock with acidosis, mortality is extremely high, and no one is 100% sure.

All we can pray is that the pollution has not spread to the point of no return.

"Okay, I see, you can do your best!"

……

In the operating room, Su Xintong stood in front of the instrument table to count the instruments, and Chen Xu was also making preoperative preparations in front of the operating table.

Li Xiyang walked in after disinfection and asked, "How is the patient?" ”

Chen Xu hurriedly said, "The patient's blood pressure has just dropped to 75/32Hg, and I have rehydrated and expanded the volume, and the blood pressure has returned to 85/55Hg." ”

Li Xiyang glanced at the ECG monitoring and nodded, "Very good!" ”

disinfect

Spread sterile sheets,

Li Xiyang stood under the shadowless lamp and began the operation!

Because it is ectopic appendicitis, the use of laparoscopy will cause great difficulties, so open surgery is chosen.

As soon as the knife went down, yellow exudate immediately gushed out of the abdominal cavity.

fishy odor,

Turbidity.

What's even more exaggerated is that the omentum under the surgical field covers the entire right lower abdomen.

The appendix is not visible at all.

……

Doctor Global Network.

Because it was night, there were a lot of people.

So as soon as Li Xiyang started broadcasting, nearly 2,000 people immediately poured into the operating room.

These people can be regarded as iron fans, and nearly half of them have watched Li Xiyang's first live broadcast.

"Haha, I finally waited for you, fortunately I didn't give up~"

"What surgery did Oba do today?"

"Hey, pain in the right side of the abdomen, accompanied by nausea and vomiting, partially relieved after spitting out the stomach contents, tenesmus, this is acute cholecystitis!"

", didn't you see a small calculus 45 in the right kidney, this is a kidney calculus!"

"Hehe, 5's kidney stones are just a matter of one soak of urine, of course, one soaking is not good, two soaks, who would take a knife for this?"

"What's this..."

"Don't talk, the operation has begun!"

Under the shadowless lamp, the scalpel is bright.

The next second,

", where is there so much fluid in the abdominal cavity? What the hell is this infection! ”

"Haha, it turns out that the elder also digs dung!"

In the operating room, Li Xiyang held a suction device to aspirate the patient's ascites effusion.

A large amount of pus and food debris is cleaned out.

You can smell it almost through the screen, and the sailors call it out one by one.

But there are also some who are not surprised.

"What's this, I did a case of intestinal perforation a few days ago, and 50 ml of light pus was withdrawn, can you believe it?"

"Hehe, Lao Tzu opened hemorrhoids and was sprayed with, are you comparing with me?"

"The elder didn't open his mouth at that time, did he?"

"Fool with a mask!"

"Poof~ha..."

Everyone joked with each other, and at this time, someone on the barrage frowned, "It's not good, it turned out to be appendicitis surgery!" ”

To provide you with the fastest update of the Great God Xinglin Holy Hand's Great Power Chief Surgical Holy Hand, in order for you to see the fastest update of this book next time, be sure to save the bookmark!

Chapter 106: Misdiagnosis Free Reading.