"Teacher Wu, take a look at it and see if this is it. Han Quinn said. /br

"Look at the film. Wu Mian smiled. /br Han Kuien opened the film reader, hit his shoulder, Yang Lei stumbled, and was directly knocked away.

/br The film was inserted into the reader, and Yang Lei and Wei Dabao didn't understand it after watching it for a long time. /br

"It's here. Wu Mian clicked on the film and said,

"There is a small amount of hematoma in the rectus sheath. ”/br

"Sure enough. Han Kuien said with emotion after he was sure,

"Mr. Wu, this case reminds me of the previous two particularly weird appendicitis. ”/br

"The physical examination was very clear, and when I opened the appendix, there was no swelling. I said that there was no inflammation, but I thought it must be appendicitis. It is said that there is inflammation, but it is not like it. Han Quinn recalled.

/br

"You made the knife on a normal McIss, not on the tender area, did you? ”/br

"Yes. Han Quinn nodded. /br

"It could be caused by a rectus sheath hematoma. Wu Mian smiled,

"It's a disease that is not rare, but it's particularly prone to misdiagnosis. ”/br

"Mr. Wu, is it a torn muscle?"

"The superior abdominal wall artery, inferior abdominal wall artery or its branches in the rectus abdominis sheath are ruptured, or caused by direct tearing and bleeding of the rectus abdominis muscle, and its clinical manifestations are very similar to some acute abdomen, and it is easy to be misdiagnosed as abdominal and pelvic lesions and blind surgery. Therefore, correct diagnosis and treatment are particularly important. Wu Mian said.

/br

"Sit-ups, I remember. Han Quinn was also honest at this moment, he didn't care about thinking about the problem of face, and the whole person was immersed in the rectus abdominis sheath hematoma and couldn't extricate himself.

/br

"Not necessarily. Wu Mian said,

"The last patient I saw with a rectus sheath hematoma was a general ...... Ahem. ”/br

"Datong what?" Han Kuien asked subconsciously. /br

"It's an American celebrity. Wu Mian said,

"Found pain in my abdomen after playing golf. I happened to be nearby, so I was asked to see it. Finally, CT was performed, and the diagnosis was confirmed as rectus sheath hematoma. ”/br

"Local blunt trauma to the abdominal wall, iatrogenic injury, severe coughing, severe vomiting, sneezing, excessive straining to defecate, and sports such as sit-ups, standing long jump, and golf, can cause excessive contraction of the abdominal muscles and uncoordinated movements, resulting in rectus abdominis sheath hematoma. ”/br

"To add a little more, high blood pressure, atherosclerosis, pregnancy, and childbirth are also common risk factors. Wu Mian said,

"Childbirth, in particular, is a common trigger. Wu Mian explained plainly.

/br A rare case almost snapped his fingers and said one, two, three, four, five, which made Han Kuien feel ashamed.

Hearing Mr. Wu say this, it seems that it is not unusual. /br

"I remembered. Han Kuien nodded again and again, these things are difficult for ordinary people to memorize.

But for an old doctor with many years of clinical experience, it doesn't matter at all. /br doesn't need to be memorized, just understand.

/br

"Mr. Wu, since it is a hematoma, do you say that it is not possible to do B ultrasound? I think B ultrasound seems to be able to make a clear diagnosis. Han Quinn asked,

"And the B ultrasound can also look at the pelvis and the appendages, killing two birds with one stone. Wu Mian smiled with satisfaction,

"Director Han, your level is good. ”/br

"Huh?" Han Quinn was stunned. /br

"This is a question that people with a slightly worse level will not think of. Wu Mian said,

"Ultrasonography is an important auxiliary means for the diagnosis of rectus sheath hematoma, which can be used as screening, post-treatment re-examination and examination of pregnant women, and its diagnostic sensitivity is high, but some cases lack diagnostic specificity and are easily confused with cystic masses containing separation, and the overall diagnostic accuracy is 70%~90%. ”/br

"Conventional CT scan can well show the location, extent and relationship between hematoma and surrounding tissues, and is the preferred examination method for diagnosing rectus sheath hematoma, with diagnostic accuracy and specificity of 100%, and can further classify hematoma, guide clinical treatment, and judge prognosis. ”/br

"Oh oh oh, I see. Han Quinn said thoughtfully after comparing the images of the two auxiliary examinations.

/br

"CT findings of rectus sheath hematoma may vary with increasing time of onset. The /br acute hematoma is hyperdensity, then gradually turns into a mixed density, and finally absorbs and liquefies to a low density, so when the CT scan is atypical, it is necessary to pay attention to distinguish it from the rectus abdominis neoplastic lesions, and further contrast-enhanced scan can help confirm the diagnosis. The point is also to ask for medical history, for example, ......"/br Wu Mian gushed about it, just a CT film of a rectus sheath hematoma, and he told Han Quinn for half an hour.

/br Wei Dabao listened to the dew, originally thought that he could do it, but he didn't expect that it was just one

"Small" problem: Section Chief Wu can tell so many moths. /br

"MRI is useful in differentiating rectus sheath hematoma from other anterior abdominal wall masses and is often used to diagnose patients with atypical CT signs and contraindications to CT-enhanced scanning. Most patients with rectus sheath hematoma are completely resorbent with conservative management and have a good prognosis. Wu Mian finally finished speaking, he smiled and said,

"Explain the rest to the patients, I think they believe in you. ”/br

"Good, good, good. Han Quinn said three good words in a row. /br

"Then I'll go home. Wu Mian said,

"Director Han, there's a chance to see you again. /br watched Wu Mian stride away, Han Kuien hesitated, and then ran over, his waist was already bent miserably, holding his mobile phone in his hand,

"Mr. Wu, can I have the honor to leave you a contact information?"/br

"Okay, don't be so polite. Wu Mian smiled slightly, and then said the mobile phone number. /br

"I will add my WeChat friends in a while, just mark Director Han. ”/br

"Excuse me. Han Kuien watched Wu Mian leave, and he didn't straighten up until the figure disappeared for 20 seconds.

/br

"Director Han. Only then did the patient's family dare to lean over and ask in a low voice. Han Quinn explained to him the rectus sheath hematoma, and taught him how to treat conservatively and how to do hot compresses when he went home.

Although Wu Mian has left, Han Kuien is like being treated in front of Wu Mian, and he doesn't dare to make any mistakes.

After /br took care of everything, Han Kuien called a car and left the Bajingzi Traditional Chinese Medicine Hospital. Teacher Wu is indeed young, but the level of the family is really high, Han Kuien thought to himself.

The /br level is high, and there are no shelves. At the beginning, his tone seemed to be a little rushed, but Mr. Wu didn't take it seriously, and still explained to himself the rectus sheath hematoma in a gentle voice.

/br Han Quinn didn't go to the dinner, but went straight home. Along the way, he was sighing that Mr. Wu was really a person with no frame and ability.

/br didn't say anything all night, and the next day Han Quinn got up early in the morning to make rounds, went through the test sheet of the patient for surgery again, and went to pick up the plane at noon, ready for the professor to come to the operation.