Doctor, is my wife seriously ill?" In the emergency room, a middle-aged woman came out with the internal medicine doctor.

Zheng Ren was stunned and heard someone talking in his ear.

"Severe!" said the doctor with certainty: "Gastrointestinal bleeding, and there is a faucet whizzing blood. Do you think it's heavy?"

The emergency physician said, looked up and saw Zheng Ren, and greeted: "Mr. Zheng, is the director's illness okay?"

"It's okay." Zheng Ren smiled, "What patient?"

"Naught, vomiting, and low blood pressure. Considering it, upper gastrointestinal bleeding, it is ready to be admitted to the hospital."

This situation is more common. Tips surgery is a type of portal hypertension patients with gastric fundus and intestinal mucosa, and also a type of rupture and bleeding.

If it weren't for portal hypertension and cirrhosis of gastrointestinal varicose veins, the bleeding arteries would generally not be very large. If you were admitted to the hospital, you would be able to decompress the gastrointestinal tract and stop bleeding. It would be almost done in 2-3 days.

"How much blood pressure?" Zheng Ren asked casually.

"75/50mmhg." The emergency physician took the patient's family to issue a hospitalization form, leaving Zheng Ren with a data.

Fortunately, although it is shock, blood pressure, it is not particularly low.

Zheng Ren looked at it and saw a middle-aged man lying on the bed in the emergency room, with a pale face and the values ​​displayed by the electrocardiogram monitoring...

Why is the blood oxygen saturation so low? There are also some problems with the waveform of the electrocardiogram.

Zheng Ren felt something was wrong and walked in and took a look.

The system panel is scaryly red, and the diagnosis is like bleeding - a large amount of pericardial effusion and an aortic outer membrane ulcer.

Uh...what disease is this?

Zheng Ren knew that the doctor in the emergency department had a wrong diagnosis. As for why he made this mistake, he didn't think about it for the time being.

He immediately opened a drawer on the operating table, which contained a mercury sphygmomanometer and a stethoscope.

Picking up the stethoscope, Zheng Ren began to auscultate the patient.

A large number of damp slugs can be heard in both lungs, and the heart sound is low and far away. It is indeed the heart sound of the pericardial tampon.

Because he was a man, Zheng Ren did not check if there was any patient who had "disguised" last time.

Pericardial tampon is also divided into acute and chronic. If it is traumatic, the heart will be broken into a large hole and the blood will not be discharged. It is piled in the pericardial cavity, which is acute pericardial tampon.

If the heart is insufficiency and renal insufficiency may lead to fluid circulation disorders and chronic pericardial tamponade.

It is understandable that pericardial effusion or even pericardial tamponade occurs. But what is the hell diagnosis of the aortic episomal ulcer? How did it come about?

The aorta also has ulcers. This situation refers to the rupture of the aortic atherosclerotic plaque to form ulcers, and the ulcer penetrates the inner elastic layer.

However, what the big pig's hooves gave was an aortic episomal ulcer.

Is there any inflammation? Or something else?

Just as I was thinking, the emergency physician took the hospitalization form for the gastroenterology department and walked out and asked the patient to accompany the examination to take him to the hospital.

She saw Zheng Ren checking his body in front of the bed and asked, "Mr. Zheng, what's wrong."

"Don't rush to be hospitalized, and have a lung ct." Zheng Ren said: "What is the medical history?"

The emergency physician was stunned for a moment and had a clear upper gastrointestinal bleeding. Why didn’t Mr. Zheng let him be admitted to the hospital and even had to undergo a pulmonary CT examination?

"The male patient, 42 years old. He came to our hospital for treatment for repeated nausea, vomiting and difficulty breathing for 3 hours." Although there were any questions, the emergency physician still habitually reported his medical history.

The superior doctor's tyranny is not a joke, and he has long been used to becoming natural.

"The patient suddenly had difficulty breathing 3 hours ago, with a slight chest tightness, accompanied by nausea and vomiting, and each time it was a small amount of stomach contents and a small amount of brown-colored objects, without abdominal pain, and had no relationship with the eating position. There was incontinence of the stool and the stool was yellow and thin."

"Narrhea and vomiting? Coffee color?" Zheng Ren asked.

"Well, occult blood is positive, and it is considered that it is caused by upper gastrointestinal bleeding. Because there is no vomiting of blood, the bleeding should not be very serious." said the emergency physician.

Zheng Ren pondered.

Something was not right.

According to medical history, the diagnosis of emergency physicians is correct.

Nausea, vomiting, and vomiting are given for testing, and there is a positive occult blood test. Inferred by gastrointestinal bleeding. All of this is logical and there is no problem.

But why do you have difficulty breathing?

Seeing Zheng Ren staring at the patient in a daze, the emergency physician whispered: "Mr. Zheng, hurry up and send it to the gastroenterology department. If the bleeding cannot be stopped, you will have to rescue it."

Is the emergency department? After the diagnosis, you can take whatever you need.

They are all in the emergency department for rescue, so they are too busy.

There were more than a dozen emergency patients outside, and they met someone with a bad temper and in a hurry, and they just opened their mouths and cursed.

Even if you get beaten, it is not uncommon.

It is not uncommon to rescue him in the face.

Zheng Ren shook his head and said, "Go and get a lung ct, I'll take the patient to have a test."

The emergency physician didn't know why Zheng Ren insisted, so she didn't hesitate. The superior doctor said it and he also gave his own opinions. If he didn't listen, then follow the superior doctor's instructions to execute it first.

When the sky falls, there is a superior doctor who is holding on to it. What are you afraid of?

"What patient, boss." Su Yun returned to Zheng Ren after dealing with the female student.

"It's very strange, listen." Zheng Ren gave Su Yun the stethoscope.

"Hmm? Strange?"

"According to the medical history, the patient was diagnosed with upper gastrointestinal bleeding, and there was no doubt. However, there were problems with both lungs and pericardial auscultation, so I plan to take the patient to do a CT first."

Su Yun took the stethoscope skeptical and began to auscultally.

Less than a minute, he looked up with a serious expression and said, "If you have any questions, hurry up and check it."

After saying that, Su Yun asked again: "Upper gastrointestinal bleeding?"

"Naught, vomiting, vomiting occult blood test positive."

"Mr. Zheng, the CT order has been issued, are you taking it there?" asked the emergency physician.

"Um."

The patient's family was a little confused. He just said that he was sent to the Department of Gastroenterology for hospitalization. The doctor also described the condition very seriously. If he was a little later, he might die. Why do he have to undergo another examination now?

"Doctor, what's going on?" the patient's family asked anxiously.

"Have you suffered an injury recently?" Zheng Ren didn't explain, and asked while lifting the patient onto the flat car with the accompanying test.

"Recently? No." said the patient's family: "I suffered an injury just a few years ago, with a collarbone fracture and had surgery. There was nothing happening recently, it's normal."

Zheng Ren glanced at the patient's left sternum area had old surgical scars, which happened a long time ago.

Strangely, without trauma, where does the aortic epistomy ulcer come from?

According to the diagnosis of the big pig's hoof, Zheng Ren began to think about it.

But no matter how you think about it, it is a dead end and there is no idea at all.

Zheng Ren and Su Yun pushed the flat cart, trotted all the way, and took the patient to the CT room with the accompanying examination.

It was not until the patient went to the clinic and started doing CT that he took a breath.
Chapter completed!