My stomach is a little tight...

This is not normal. A normal person's abdomen should be loose when lying flat. No matter how much or hard your abdominal muscles are, your stomach should be soft.

Moreover, this patient is already unconscious, why is his stomach hard? And it is tight!

This man is fat, obviously not abs...

Yao Zhiwen suddenly discovered this situation and quickly touched it, and was stunned!

"Muscle tension?"

Abdomen is tight, which often indicates inflammation in the abdominal cavity. The inflammation stimulates the peritoneum and causes the abdominal muscles to tighten, so you feel a little tight when you touch it.

Could it be that the patient's myocardial infarction caused abdominal tension?

At this time, the electrocardiogram result came out. The nurse handed it over, Chen Cang took it over, looked at it carefully, but still didn't see a typical myocardial infarction pattern.

Chen Cang couldn't help asking the family members: "How long has it been since the attack?"

His wife was confused: "It's been several hours, right? Three or four..."

Chen Cang looked at Yao Zhiwen: "It doesn't look like a myocardial infarction! It's been three or four hours. If it's really an acute myocardial infarction, there should be a significant electrocardiogram change."

Chen Cang couldn't help asking, "Is there any breast radiograph?"

Is there another reason for chest pain?

Yao Zhiwen brought the film over, and Chen Cang saw it, it was basically normal!

Is this strange?

What the hell is going on!

Chen Cang's brain flew rapidly, thinking about various possibilities.

Thoughts are thinking, but Chen Cang's hands have not stopped and has been checking the patient's abdomen, trying to find more information.

Just as he routinely performed a liver perforation examination on the patient, he found that the patient suddenly frowned and showed a painful expression when he was poking his liver.

This shocked Chen Cang!

What does this mean when you, a coma patient, have a painful expression?

There is only one possibility!

That is, Chen Cang did hurt him!

Well, this is not nonsense, it is true!

Even when a person is in a coma, he still feels severe pain.

However, a normal person will not have any reaction to percussion in the liver area, unless he has liver and gallbladder system diseases!

And it is also those acute inflammatory diseases, such as liver abscess, cholecystitis, bile colic, etc.

When my wife saw the man with a painful expression, she thought he was awake and quickly patted and slapped his ear and called his name loudly, but she did not react at all.

In order to further verify the idea, Chen Cang placed his left palm flat on the lower part of the patient's right chest and pressed the gallbladder area with his left thumb. If the patient has gallbladder inflammation, such a deep pressure will inevitably cause severe pain in the patient. Because the gallbladder is under Chen Cang's thumb.

really!

When the left thumb pressed down deeply, the patient frowned even more violently and twisted together!

Chen Cang immediately let out a long sigh.

It is true that the patient is in shock, but the patient is not in cardiogenic shock, but may be in septic shock.

Cardiac shock refers to shock caused by heart disease. If it is myocardial infarction, interventional or thrombolytic treatment should be done immediately.

But if the gallbladder infection is severe and the septic shock occurs, the treatment will be completely different.

Inflammation of the gallbladder and bile duct may also cause chest pain. Although there are fewer, it is possible. Conversely, myocardial infarction may also cause abdominal pain rather than chest pain.

The human body is very complicated, it is definitely not a simple way to get sick if it hurts!

At this time, the patient is likely to have a gallbladder system disease!

Chen Cang: "Give me the test form."

If you make both mistakes and miss the opportunity for treatment, the patient may die.

After taking the patient's test report and after careful consideration, the blood routinely indicated that the white blood cells were too high, not too high.

However, myocardial infarction itself can lead to high white blood cells and infection, so we cannot distinguish them by blood routine alone.

Chen Cang looked at Yao Zhiwen: "Replenish the fluid first! Replenish the fluid in large quantities!"

Yao Zhiwen also understood what happened at this time: "You mean... are you worried about septic shock?"

Chen Cang nodded!

In fact, whether it is cardiogenic shock or septic shock, it is correct to replenish fluids at this time.

As long as the patient's blood volume is increased and the blood pressure is increased, the blood supply and oxygen supply of each organ can be ensured. Otherwise, those ischemia-hypoxia organs will starve to death one by one!

"Notify the emergency consultation in the ultrasound room!" Chen Cang made a decisive doctor's advice.

The young nurse quickly picked up the phone and started practicing.

In order to be foolproof, Chen Cang again conducted a detailed physical examination for the patient. There were not many abnormalities in the cardiopulmonary auscultation, and another chest radiograph did not indicate the symptoms of pulmonary edema. After another electrocardiogram, he still did not see a typical manifestation of myocardial infarction. The patient is really not a myocardial infarction!!!

Chen Cang is basically sure!

To diagnose myocardial infarction early, the most objective method is to keep doing electrocardiograms.

Electrocardiograms are both cheap, convenient, and have no radiation, and can provide huge value. They are really a rare and easy to check.

The b-super room is nearby, and soon they pushed the machine over.

Not long!

The inspection results are out.

As a result, Chen Cang and Yao Zhiwen were shocked!

B ultrasound saw that the gallbladder was significantly enlarged, the gallbladder and bile duct walls were thickened, there were many stones in the gallbladder, and the bile duct was significantly expanded!

All this shows that the patient's gallbladder and bile duct are inflammation, and it is very likely that it is acute obstructive suppurative cholangitis.

Once the stones block the common bile duct and the bile cannot be discharged from the digestive tract smoothly, it will inevitably accumulate more and more, which will eventually lead to an increase in the pressure in the bile duct, bile flows back into the blood, and accompanied by bacteria entering the blood, which will produce obvious symptoms of sepsis. In severe cases, shock may occur.

Chen Cang took out the phone and called Zhang Youfu directly. Zhang Zhixin happened to be on duty and ran down, running and jumping!

Discuss with Mr. Bai of B Super League.

The patient's condition was comprehensively evaluated and the patient was clearly considered. Acute obstructive suppurative cholangitis and septic shock were recommended. It was recommended to transfer to general surgery immediately and perform bile duct decompression drainage in time. As long as the bile duct is incised and the swelling bile will flow out, the condition will be significantly improved.

As for... the gallstone issue, it is fine to discuss it and cut it slowly later.

After the patient was sent away, Yao Zhiwen was so scared that he was sweating heavily.

Chen Cang patted his back and found that he was covered in sweat.

Yao Zhiwen had tears in his eyes: "Chen Cang...you said...if I didn't invite you...will he be gone?"

One sentence made Chen Cang stunned.

Chen Cang sighed, not knowing what to say.

The diagnosis of a disease is too complicated, so who can guarantee that he can diagnose it accurately?

Chen Cang has a plug-in, but he can't see through it at a glance. If he hadn't touched it lightly, Chen Cang himself wouldn't have guaranteed...

Chen Cang looked at Yao Zhiwen, he couldn't blame him...

Diseases are ever-changing. The symptoms between different diseases often cross the auxiliary examination. If not carefully distinguished, it is very easy to make mistakes.

So.

Doctors should be trembling and walking on thin ice!

At this time, Dr. Yan came back... with the doctor in the Department of Cardiology.

Chen Cang sighed and looked at Yao Zhiwen: "You are very outstanding, at least you didn't run away..."

Yao Zhiwen burst into tears, and she was really laughing and crying, and tears were flowing down her face.

"I really want to be a good doctor!"

Chen Cang smiled: "You are already..."

What else can you say besides comforting him?

Yan Ming hurried over: "Xiao Yao, where is the person? Where has the patient gone?"

Seeing Yao Zhiwen crying, Yan Ming was so scared that he shivered: "Is the person leaving?"

Chen Cang sighed, shook his head, and returned to the emergency surgery department.
Chapter completed!