FVN Chapter 324
Chapter 324
PS: Close to the case, attach a simple decomposition diagram of the digestive system.
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"Let's send the ICU first..."
Lin Feng glanced at the female patient on the bed who was constantly fighting shock,
The blood doesn't stop.
He was afraid that the equipment in the rescue room was not enough and he died in the rescue room.
Preferably, or send the ICU,
Then under the supervision of many instruments in the ICU, hemostasis is carried out.
Even if the heart stops or some other accident during the rescue process, you can immediately organize efficient rescue.
With the escort of ICU Shen Bei, he is also relieved.
"Xiao Ai, you go to the ICU and tell me about the situation..."
"Yes!"
A minute later,
Xiao Ai returned: "Dr. Lin, the ICU said that there is a bed. "
Lin Feng nodded: "Okay, go, go to the ICU!" "
......
After 10 minutes,
Push to the ICU...
Reconnect the ECG monitor.
The state of shock continues.
Plug in the ventilator... and other monitoring equipment.
With these equipment, Lin Feng can finally perform colonoscopy with confidence.
The colon, which is the penultimate intestine of the human digestive tract, is a large intestine, and the whole is M in shape (ascending colon from the right abdomen up - transverse colon from the upper abdomen - descending colon down from the left abdomen - terminal sigmoid colon). (ps: Book lovers can compare it themselves, look at the picture digestive tract 'jpg)
And behind the colon, there is: rectum (relatively short) - steel gate ...
Colonoscopy starts from the steel door to enter, then passes through the rectum, and then descends the colon, transverse colon, ascending colon...
Therefore, doing this "colonoscopy" can detect the bleeding of the rectum and colon.
......
Colonoscopy, begin.
"Hope it will succeed..."
Lin Feng stretched the camera all the way in...
I have always seen the rectum, sigmoid colon, descending colon, transverse colon, ascending colon....
The first pass...
Inch by inch to find...
It took 20 minutes...
outcome
Didn't find it!!
Lin Feng: "???? "
What the heck?
How can I not find a bleeding spot?
All the intestinal walls are bare, only traces of blood flow, and no active bleeding openings are visible.
Confused, dazed ...
Lin Feng is not dead...
The second time, keep looking...
Still didn't find it!
The third time,
Still haven't found it!
And blood, at this time, has already entered 4000 ml!
However, Lin Feng still didn't see the bleeding spot!
Lin Feng stopped moving.
Frowning.
"Why?"
"Logically, it should be the lower digestive tract?"
Lin Feng thought about it,
"Isn't it colon bleeding? But the ileum? Or an empty field? "
(Ileum, empty field: all small intestines...) The so-called small intestine is five or six meters seven or eight meters, which refers to these two sections of intestine... ）
But
It is difficult to do the examination of the ileum and empty field.
Because it's too long!
It's too thin too!
Lower section: colon, rectum, steel door (colonoscopy has been examined)
Midsection: ileum, empty field (difficult to check)
Upper section: stomach + duodenum (gastroscopy can be performed)
Lin Feng felt that when doing ileal and jejunal examinations,
It is necessary to do gastroscopy first,
Exclude the stomach + duodenum first.
In general,
Gastric and duodenal bleeding is unlikely to cause bright red bloody stools, usually black stools.
Why?
Because of the bleeding of the intestinal tube in the anterior section of the stomach and duodenum, the blood passes through the small intestine of several meters of intestine and then excretes the steel door, which is already not fresh, and has long been digested in the intestine and turned black.
This digestion process takes more than 48 hours.
Of course, this is the general case.
There is also a special case,
Blood is not digested directly, all the way like water, directly flowing through the long digestive system, flowing out through the steel door...
This process only takes a few minutes.
Blood can remain bright red.
So
Gastroscopy of the stomach + duodenum is still necessary.
......
Gastroscopy begins,
Gastroscopy is different from colonoscopy, not through the steel door, but through the mouth.
Lin Feng slowly put the gastroscope into the mouth, the base of the tongue, through the throat into the esophagus, and then to the stomach and duodenum.
Scrutinize......
As soon as you enter the eye,
Lin Feng probably ruled out here.
Why?
There is no blood!
Lin Feng searched for a long time, but he didn't find a bleeding hole, not even a trace of blood.
Obviously, the patient's blood definitely did not come from here.
So
It can only be an empty field + ileum ...
Maybe there is a blood vessel ruptured in the jejunum and ileum, and it is bleeding proudly.
......
At this point,
The husband of the female patient also rushed outside the hospital gate.
In my heart, I scolded that Tesla over and over again.
Tesla Black Powder +1...
Dashing to the emergency department...
"Hello nurse, I am Wang Jiali's husband, where is my wife now?"
"Wang Jiali... Oh, she sent the ICU? "
"What does ICU mean?"
In his heart, the husband slammed.
"ICU means intensive care unit, your wife's condition is more serious, so send the ICU to compare insurance."
Illness...... Quite serious...
Hearing this, the husband's whole person was stupid!
"Where's the ICU?"
"Inpatient Department, 9th floor..."
"Thank you..."
Without looking back, he rushed straight out of the emergency department.
Ran all the way to the ICU.
The ICU door was always closed, he rang the doorbell, and soon the nurse came over.
"Who are you?"
"I am Wang Jiali's husband, and my wife just sent me here..."
"Oh, it's you, why did you come, the doctors have been looking for you for a long time, hurry in..."
"My wife doesn't matter..."
The husband entered the ICU and asked nervously.
"I don't know, wait until you ask the doctor..."
Came to the hospital bed, at this time Lin Feng was busy checking.
The doctor of the ICU explained to her husband: "Your wife is not optimistic now, gastrointestinal bleeding, but did not find the location of the bleeding, and then has hemorrhagic shock, and is now on anti-shock treatment... In addition, Dr. Lin is finding out the location of the blood, and has just finished colonoscopy and gastroscopy..."
"Now officially give you a critical illness notice, you wait outside, we will deal with it first."
After speaking,
The doctor drove the patient to the usual lounge of the doctors and nurses.
Before the husband left, he looked at his wife lying on the bed, his face turned pale and fainted,
I couldn't help but grab my hair in annoyance, regretting it endlessly.
......
Next
It is necessary to find a way to see the "empty field" and "ileum".
But
There is no way to do it with a colonoscopy.
Because it's too thin and too long.
Lin Feng decided to use one method: intervening...
Intervention, you can find the bleeding port through angiography, and you can block the bleeding port through intervention!
Kill two birds with one stone!
。