The cases are not long.

Just a few words.

But it can see a lot of information.

Sometimes doctors only read medical records.

First, we find the cause based on the symptoms, and second, we find the symptoms based on the causes.

At this time, the patient's symptoms do not seem to be very difficult to have short legs.

Symptoms, the patient may have sudden dizziness, weakness, etc., which may be a sign of hypovolemia, and may also have symptoms of sudden abdominal pain, abdominal distension and other irritation symptoms of intraperitoneal bleeding!

In terms of signs: there are signs of rapid pulse, low blood pressure, and obvious peritoneal irritation, which should indicate an intraperitoneal lesion.

Blood routine indicates a progressive decline in hemoglobin at the beginning of the disease, while mcv and mch have not changed significantly. Instead, fib continues to be low and d-dimers have increased significantly. These seemingly messy test reports can clearly draw a conclusion, which is completely consistent with the manifestations of acute blood loss!

So Chen Cang said directly: "Consider acute hemorrhagic diseases!"

Chen Cang's diagnosis was almost given directly after the case was explained.

Several directors looked at each other frequently and were full of appreciation.

Although this diagnosis is not difficult,... it takes a certain level to get acute bleeding so quickly.

Chen Cang basically blurted out, which shows the other party’s solid foundation!

Huang Qiuying couldn't help but nodded: "That's right, since it is a hemorrhagic disease and lower abdominal pain, physical examination and imaging found solid tumors in the pelvic cavity, and the patient himself has a gynecological history, so I first consider gynecological related diseases.

There are only a few gynecological diseases that can cause bleeding!

First of all, pregnancy-related diseases: such as ectopic pregnancy, trophoblast tumors, etc.

The second is rupture of ovarian or fallopian tube tumors;

Finally, the ovarian endometriosis cyst rupture.”

Chen Cang nodded: "The patient has been menopause for many years and can completely rule out pregnancy-related diseases, and endometriosis cysts are unlikely!"

Thinking of this, Chen Cang suddenly asked, "Did the patient fall?"

Choi Jisheng nodded: "Yes, but... that just slid to the ground gently."

Sliding gently to the ground is different from falling heavily to think about the angle.

Huang Qiuying said: "Before the diagnosis of bleeding caused by gynecological diseases is established, bleeding caused by other systems and other causes needs to be ruled out."

As the director of general surgery, He Zhiqian said: "We have discussed it before. Surgery internal abdominal bleeding is generally seen in organ damage."

"However, injuries to parenchymal organs such as the liver, spleen, pancreas, etc., cavity organs such as the stomach, intestines, gallbladder and bile ducts, etc. In addition, there are blood vessel injuries such as the abdominal aorta, inferior vena cava, etc. Generally, these injuries are secondary to severe closure or perforation injuries, and pelvic blood vessels are mostly secondary to perforation injuries, pelvic or lower limb fractures.

Therefore, the patient fell to the ground slowly after minor activity and had no obvious fractures, which generally did not cause damage to the above organs and tissues."

He Zhiqian's words directly denied the possibility of the patient's organ damage.

Next, the Urology, Hematology, Endocrinology, and Interventional Department began to discuss it again.

Perhaps many people don’t understand what consultation is?

This is consultation, giving an inferred diagnosis, and then the diagnosis is carried out by each department.

This is the benefit of dividing subjects.

Every doctor is proficient in one field!

They are very good at ills in their field.

Continuously narrowing the possibility of patients.

An acute intraperitoneal bleeding may seem ordinary, but it is now impossible to give a clear diagnosis.

Actually, this is medicine.

As Sir William Osler, one of the founders of Johns Hopkins Medical School, said: "Medical science is an uncertain science!"

The discussion became anxious again at this time.

Urology rejects the possibility of bladder area damage and does not consider urology-related diseases for the time being.

The hematology department’s inference focuses on vascular damage. After all, long-term vascular lesions secondary to chronic diseases such as diabetes can easily lead to bleeding.

Another round of discussion ends.

Everyone was silent again.

Generally speaking, consultation is actually in steps.

If the condition is diagnosed, it is easy to say.

but……

If this is the case today, after a long discussion, people can’t find the cause of the disease.

Consultations will not be wasted!

Consultations will gradually become a stolen conference.

After all, such a difficult patient has no clear diagnosis now, let alone treatment.

In fact, it can only be said that the patient's condition is pretty good.

If the condition is really serious, the first step to do is to have a laparotomy.

Sometimes, imaging examinations are limited.

There must be some bleeding, but the amount of bleeding is not very large.

At this moment, the office fell into silence again.

Huang Qiuying was also decisive: "Notify the operating room and prepare for a laparotomy!"

It doesn't make sense to drag on now.

At this time, Chen Cang was constantly thinking about various possibilities.

I have thought about the routine diagnosis completely, but... it does not meet the patient's symptoms.

No wonder everyone had an hour of consultation and discussion without results.

At this moment, Chen Cang suddenly said, "Can I go see the patient?"

Huang Qiuying turned around and looked at Chen Cang, then she realized that Chen Cang had not expressed any comments since he came.

Everyone also thinks that this kid Chen Cang... won't make a comeback, right?!

But no one would force Chen Cang, after all, he was just a training doctor.

He has no responsibility for giving or not.

but……

To be honest, these directors must not believe that Chen Cang can give the result.

When Huang Qiuying saw that Chen Cang was serious, she didn't seem to be pretending, so she couldn't help but be stunned: "Okay!"

While talking, Huang Qiuying took Chen Cang to the ward in person.

An old lady in her sixties was lying on the bed, covering her stomach and moaning uncomfortable.

Seeing Huang Qiuying coming, I was about to speak when I suddenly saw Chen Cang!

Suddenly, the old lady blushed: "Professor Chen!"

The old lady’s husband Cui Jisheng couldn’t help but say, “Wife, don’t worry, Professor Chen can definitely diagnose it clearly!”

The old lady nodded and suddenly felt that her stomach was not so painful: "Yes, yes! I believe Professor Chen!"

Chen Cang also sighed, the pressure was so great!

Only love and trust cannot be let down!

The directors around them had different expressions.

If Chen Cang really had a clear diagnosis, he would be able to do it.

But... to be honest, this disease must be so simple, and it will not be until now.

This kind of bleeding is absolutely rare!

Sure enough, after Chen Cang tapped the test, he was in a deadlock and could not get the exact answer for a long time!

However, Chen Cang's eyes were not perspective after all.

There is no way to see what is inside the abdominal cavity.

The patient's pelvic hematoma seems to have become an unsolved mystery.

Time passes by minute by minute!

Chen Cang also racked his brains to think!

What are the acute abdominal symptoms?

His mind was like a search engine, constantly bringing in, thinking, and repeatedly speculating.

Chen Cang suddenly thought of something and quickly said, "Do you have a color ultrasound of the upper and lower limbs!"

Huang Qiuying frowned: "What's the meaning of upper and lower limbs?"

The doctor in the interventional department couldn't help but twitch when he heard Chen Cang's words!

"Yes, do a color ultrasound!"

When Huang Qiuying heard the incident of the interventionist doctor, she was not stopped.

There is ultrasound in the gynecology department, and the results are soon revealed!

Color ultrasound of the upper and lower limbs also indicates thrombosis of the right femoral and popliteal vein!

Everyone who saw the results was a little confused.
Chapter completed!