"So you're like this because you sneezed?"

Hearing what the fat guy said, Zhao Sheng was also a little stunned and said to the thin guy with a crooked neck.

And Song Wei, who was standing on the side, already felt a little unbearable to laugh, but she immediately held back.

We're professionally trained, and no matter how funny we are, we won't laugh unless we can't help it.

Next, Zhao Shengcai learned the cause and effect of the incident from the mouth of the crooked neck guy.

It turned out that on a sunny morning, the guy who was sitting in the dormitory watching the young lady dance on his mobile phone suddenly smelled a very strong cologne smell around him, and he had allergic rhinitis, and suddenly felt a feeling of wanting to sneeze.

Perhaps he didn't have any paper at hand, or maybe he didn't want to make a loud noise, so he suddenly pinched his nose and closed his mouth tightly, trying to swallow the sneeze alive.

However, unexpectedly, instead of holding back as desired, the big sneeze "exploded" in the guy's neck.

According to the young man's account, there was a loud crackling sound behind his neck at that time, and his neck seemed to burst.

The guy originally thought that his head had exploded, but he prayed for a while and found that nothing had changed except for a little swollen neck. However, it didn't take long for the guy to find that he suddenly began to have difficulty swallowing, and his throat began to ache dullly.

Only then did he feel that something was wrong, and the fat guy who was the [culprit] immediately took the crooked-necked guy to the emergency department.

Although he was shocked by the guy's bizarre encounter, Zhao Sheng also gave the guy a detailed examination.

After examination, the boy's vital signs were stable, there was no stridor and other symptoms of respiratory distress, and there was no fever, nausea and vomiting.

There is no recent history of iatrogenic procedures or cervical spine trauma to the neck, and there is no sharp food before the onset of the disease.

The physical examination found that there was swelling and tenderness in the young man's neck, especially on the right side, and crepitations could be heard from the front of the neck to the sternum.

"Doctor, is he alright?"

Laughing and laughing, but as a good brother of the crooked neck guy, the fat guy also asked a little nervously.

Seeing the fat guy's concerned expression, the crooked-necked guy looked effortlessly at his brother sleeping on his top bunk, with a hint of emotion in his eyes.

"Do a CT scan of the neck and chest first to see if there is a pneumothorax and bronchial injury."

Zhao Sheng thought for a while and said.

Although he had never encountered this kind of sneezing too hard and causing subcutaneous emphysema in the neck, Zhao Sheng had also received a pneumothorax caused by sneezing because of sneezing.

Therefore, the guy's current situation can also be handled in this way.

"Thank you, doctor."

The guy tilted his neck and said with some effort.

Next, the fat guy accompanied the crooked neck guy to do the checkup.

When the crooked-necked guy went out, Song Wei couldn't help but smile anymore.

"How can there be such a person, a sneeze and swells his neck."

Song Wei said.

"Actually, the pressure caused by sneezing is quite high, but many people don't know about it."

Zhao Sheng thought for a while and said.

As the weather gets colder, we can see all kinds of "sneezes" in public, some of which are typed directly regardless of the eyes of others, some are shot cautiously to no one's place, and some are even held back in order to reduce the impact.

So how exactly do you sneeze go?

It is generally believed that the purpose of sneezing is to expel foreign bodies on the nasal mucosa from the mouth and nose, and the airflow speed generated by sneezing is about 30~100 m/s, and the speed of our Fuxing is 350 km/h, which is almost 97 m/s.

Moreover, the pressure generated by sneezing can reach 1 kPa in the nasal cavity. If you hold back your sneeze, the pressure can increase by a factor of 5 to 24.

If such a large pressure cannot find an outlet, it will be transferred to the upper respiratory tract, lower respiratory tract, cranial roof, orbits, ears and vascular system, causing corresponding injuries.

Even, in extreme cases, there is nowhere to vent such a lot of pressure, resulting in protruding eyes.

"Just don't hold back."

Song Wei said in a summary manner.

"Yes, if you hold it and it's not good for your body, if you feel it, you have to release it appropriately."

Zhao Sheng was sorting out the outpatient medical records, and when he heard this, he said casually.

"Huh? Dr. Zhao, I'm talking about sneezing, what are you talking about? ”

Song Wei said a little unexpectedly.

"I'm talking about sneezing, too, or else."

Zhao Sheng said.

Eleven a.m.

The crooked-necked guy took the test results and came with the fat guy.

"Doctor, the results are in."

The fat guy carefully helped the crooked neck guy to sit down, and then handed the inspection report to Zhao Sheng and said.

It can be seen that he is still very careful about taking care of the crooked neck guy, after all, he is the [culprit]!

"Okay."

Zhao Sheng nodded, took the CT report of his neck and chest and looked at it seriously.

Well, there are air streaks in the retropharyngeal region, extensive emphysema in front of the trachea, extensive soft-tissue emphysema in the neck, the base of the skull extending all the way to the T9 pyramid, and mediastinal emphysema.

After carefully looking at the examination results, Zhao Sheng had some doubts in his heart, there was no pneumothorax, no bronchial damage, and the lung parenchyma and esophagus were normal, so where did the gas come from?

"Give me the piece."

Zhao Sheng said to the fat guy.

Just looking at the examination report given by the imaging department, although it is generally accurate, it may not be possible to write all the subtleties.

After all, people are not machines, and sometimes people will miss some subtle parts of a neck or chest CT.

"Okay."

The fat guy nodded again and again, and handed the paper bag in his hand to Zhao Sheng, which contained CT films of his neck and chest.

Zhao Sheng took the film, put the film on the reading shelf, and looked at it very carefully.

Just when Zhao Sheng was looking at the film, a strange feeling arose, and as he looked at the film, the image formed by the tomography scan was gradually restored to a very complete three-dimensional scan image of the neck and chest in Zhao Sheng's mind.

This imaging is more detailed than the 3D imaging currently being done by the imaging department.

It's here!

Zhao Sheng had a flash of inspiration, and he made a discovery in an instant.

Something is wrong with the patient's right piriform fossa!

The piriform fossa on the right, relative to the left, has a very imperceptible bulge, which is most likely a tissue fistula.

Yes, the piriform fossa has the structural characteristics of lack of longitudinal muscle layer reinforcement, the guy pinched his nose and closed his mouth when sneezing, resulting in a sudden increase in pharyngeal pressure, and the piriform fossa was perforated under strong pressure, and the gas entered the subcutaneous through the perforation of the piriform fossa, resulting in a series of symptoms.

The cause of this cause is really hidden enough, if Zhao Sheng hadn't discovered this subtle change, and if someone else looked at it, he might not have been able to find it.

"Doctor, how's it going?"

The fat guy couldn't help but feel a little apprehensive when he saw Zhao Sheng looking at it again and again, looking very serious.

The crooked-necked guy was also very nervous and tilted his head and squinted at Zhao Sheng, although his appearance looked a little funny.

(End of chapter)