Reasoning diagnosis: Big brother, your wife has been prescribed medicine!

Chapter 129 Severe pancreatitis! (Please subscribe!)
After Lin Yi checked, he frowned and said:

"Now your tenderness has become obvious, and you have reflex pain, and your stomach is so tight, it's muscle tension."

"Oh, yes, it hurts me to death!"

The patient continued to cry.

His wife at the side didn't quite understand the technical terms Lin Yi said, so she just asked anxiously:

"Then...doctor, is my husband's illness complicated? How to treat it?"

Lin Yi looked at her, shook his head, and said to her:

"Looking at it now, your husband's current situation is not that simple."

"I preliminarily speculate that it may be acute cholecystitis or perforated gastric ulcer. By the way, acute pancreatitis is also possible."

"We still have to do an inspection first."

After finishing speaking, Lin Yi looked at Wu Jiang next to him, and said to him:
"Take the patient for an examination first, hurry up."

"Ok!"

Wu Jiang agreed, and immediately greeted the surrounding nurses.

"Ma'am, tell me again, what happened to your husband when he got sick today? Was it a sudden pain?"

After they left, Lin Yi turned to look at the patient's wife and asked her.

The woman nodded, frowned and said:

"A few of his friends asked us to have dinner together today."

"Then when we arrived at the restaurant, less than an hour after the dinner started, he ate some food and drank a glass of wine, and suddenly he clutched his stomach and complained of a stomachache."

"Afterwards, he took a gulp and vomited directly to the ground, with a painful expression and sweating all over his body."

"At first, the friends at the table thought he had drunk too much, and laughed at him that he was not in the right shape today. He just drank and he couldn't do it."

"But after vomiting, he directly clutched his stomach and slumped to the ground, with a painful expression and sweating all over his body, saying that the stomach pain was unbearable."

"We were all terrified when we saw this situation. We all surrounded him and asked how he was doing. He said that the pain was terrible, and we had no choice but to call for emergency services."

"And then it was sent here."

"Doctor, do you think my husband may have acute gastroenteritis?"

After finishing speaking, the woman looked at Lin Yi and asked.

"no way."

Lin Yi shook his head directly,

"Where is such severe acute gastroenteritis!"

"Muscle tension, but also abdominal tenderness and rebound pain, it cannot be gastroenteritis."

"All right…………"

The woman nodded, worried.

"Okay, just sit here and wait a while, let's wait for the test results to come out."

Lin Yi pointed to the seat next to her and said to her.

"okay."

"By the way, doctor, my husband had the experience of overeating a few years ago. Could it be related to this?"

Just after the woman sat down, she suddenly remembered, looked at Lin Yi and asked.

"Overeating?"

Lin Yi thought for a while after listening, and then said:

"According to the current situation, I think acute pancreatitis is the most likely."

"Let's wait for the inspection report first."

"Okay, okay."

The woman nodded after hearing this, and checked the information on acute pancreatitis on her mobile phone.

After a while, Wu Jiang hurried back.

"How about it?"

Lin Yi immediately looked at him and asked.

"First, the patient's blood was drawn, and then he was taken directly for CT!"

Wu Jiang panted slightly and said,

"Now that the CT results are out, the liver and gallbladder are fine, but the pancreas is obviously enlarged!"

"And the pancreas can be seen with scattered low-density areas, and the surrounding boundaries are unclear."

After listening to Wu Jiang's report, Lin Yi immediately said affirmatively:
"It seems that my guess is correct, he must have acute pancreatitis!"

"And... it can be regarded as severe pancreatitis."

"This part of the low-density area is very likely to be a necrotic focus!"

Severe illness?necrosis?
When the wife of the patient next to her heard these key words from Lin Yi's mouth, she faltered in fright!
"Doctor...Doctor, what do you think happened to him? Where is he necrotic? Is it serious!"

Lin Yi quickly turned his head to appease him:
"Ma'am, don't be anxious, calm down, after all, it's useless for you to be anxious now."

"Okay, okay, I'll calm down."

The woman covered her chest, trying to calm down her emotions, and could feel her heart beating violently.

Then, suppressing the panic in her heart, she asked Lin Yi:
"Doctor, tell me quickly, what's the matter?"

Lin Yi looked at her, and said:

"Severe pancreatitis, also called acute hemorrhagic necrotizing pancreatitis."

"In addition to the obvious inflammation, the pancreas will also have some necrosis. The low-density focus seen on your husband's CT may be a necrotic focus."

"Of course, if you want to confirm the diagnosis, you have to wait for the results of the blood test. If the blood test results show a significant increase in blood amylase, then you can confirm the diagnosis!"

The woman nodded nervously while listening, then looked at Lin Yi and asked:

"If my husband is diagnosed with this severe... pancreatitis, can he be treated?"

"If the diagnosis is confirmed, it must be hospitalized."

Lin Yi thought for a while, then said,

"It can only be fasted and watered first (cannot eat or drink), and then carry out relevant conservative treatment to see how the effect is."

"Well, let Dr. Wu take you to go through the hospitalization procedures and other matters first."

The woman nodded and asked:
"So, my husband must be hospitalized, right?"

"Of course, in this case, he will definitely not be able to leave."

Lin Yi said directly.

Although Lin Yi had made it very clear just now, the woman still couldn't help asking Lin Yi back with a little luck.

It was really hard for her to accept the facts in front of her!

His husband was eating and drinking together a few hours ago, chatting and laughing at the table, but now he is going to be hospitalized suddenly, and the condition is still serious!

This was a huge blow to her heart!

"Come on, ma'am."

Wu Jiang on the side interrupted her thoughts and said to her.

"okay."

She came back to her senses, nodded, and followed Wu Jiang out.

At this time, the water friends in the live broadcast room couldn't help discussing:

"It seems that this patient's condition is quite dangerous."

"Severe pancreatitis, I have learned about this disease before!"

"The mortality rate of this disease can reach 30%!"

"30%? The death rate is so high, is it true?"

"Of course it's true!"

"At first, when I saw his stomach ache, I thought he ate something that ruined his stomach!"

"Stomach pain can have so many possibilities. Some time ago, a patient came in with stomach pain. Isn't it quite serious!"

"So, if you have a stomachache in the future, you have to pay attention!"

After they left, Chen Qiang looked at Lin Yi and asked him for advice:
"Brother Yi, you just said that you need to look at the amylase in the blood test to confirm the diagnosis. What's going on?"

Lin Yi turned to look at him.

Looking at his serious face, he nodded slightly.

Hmm... The young man is quite studious, not bad!

Later, Lin Yi explained to him:

"Amylase is a digestive enzyme stored in pancreatic cells, which is usually secreted into the digestive tract to digest food.

"And if there is significant inflammation in the pancreas and the cells are destroyed, then these amylases will flow into the blood circulation."

"In this way, in the blood test results, you can see a significant increase in the level of amylase in the blood circulation."

"So, if we find that the amylase content in the blood is increased, then we can conversely infer that the pancreatic cells are destroyed, and there is pancreatitis!"

Hearing this, Chen Qiang nodded in understanding, and said involuntarily:
"Oh, so that's the case, I understand!"

Not only Chen Qiang, but also the water friends in the live broadcast room understood the principle.

Because what Lin Yi said was really easy to understand.

"Typically, an increase in amylase can be detected a few hours after the onset of pancreatitis."

"Let's see the result later."

After Lin Yi finished speaking, he sat down at the table and waited quietly for the result.

"Brother Yi!"

After a while, Wu Jiang broke in from the door.

"The patient has been admitted to the ward, and then his blood test results came out."

After finishing speaking, Wu Jiang handed the report to Lin Yi.

Lin Yi took a closer look and said in his mouth:

"Sure enough! In addition to the increase in white blood cells, blood amylase also increased significantly, reaching 800U/L! It seems that I guessed correctly!"

"It has been diagnosed as acute pancreatitis!"

After Lin Yi finished speaking, the water friends in the live broadcast room couldn't help sighing.

Wu Jiang immediately asked Lin Yi:
"Brother Yi, what shall we do now?"

"Go, go to the ward first!"

"it is good!"

After finishing speaking, the three of them went straight to the ward.

"Doctor, you are here, what's the result?"

The patient's wife was packing the bedding by the bed, and when she saw Lin Yi and the others coming in, she hurriedly asked.

"Diagnosed."

Lin Yi walked inside, staring at her,
"Your husband has acute pancreatitis, and it may be severe pancreatitis."

"Ah... this..."

The woman looked back at her husband lying on the hospital bed, and then at Lin Yi, so anxious that tears fell down her face.

Although Lin Yi had already said that she was very sure, but now that the diagnosis result came out, she couldn't help being stunned!
"But... why is that? My husband has always been in good health, why did he suddenly suffer from acute pancreatitis?"

She stared at Lin Yi unwillingly and shook her head.

I wondered in my heart if I made a mistake, his husband is just ordinary enteritis...

Lin Yi frowned, and slowly said:

"Your husband had the experience of overeating and drinking a lot before. Overeating will increase the burden on the pancreas, causing it to secrete excessive digestive enzymes. If these digestive enzymes cannot be excreted in time, they will remain in the pancreas. "

"They stay in the pancreas for a long time, they digest the tissue of the pancreas, and as a result, the pancreas becomes more overwhelmed, so pancreatitis occurs."

After Lin Yi finished explaining, barrages were sent out in the live broadcast room:
"Damn it, it turns out that's the principle!"

"The anchor's speech is so detailed, I actually understood it!"

"To put it simply, overeating stimulates the secretion of a lot of digestive enzymes, and then the digestive enzymes cannot be excreted, and it will backfire on the pancreas."

"This pancreas is also miserable enough, being hurt by the substances it secretes..."

"Yes! This is embarrassing."

After listening to Lin Yi's words, the woman asked:
"So... his illness was caused by overeating?"

"Well, yes, that's the main reason."

Lin Yi nodded in affirmation.

The woman immediately turned around and looked at the patient on the hospital bed bitterly, and said loudly:

"Look! You did it all yourself!"

"In the past, you went out to eat and drink every day, and drank until midnight at night. You didn't listen to what I said to you!"

"You feel young and in good health, are you better now?!"

"Deserved!"

After the woman finished speaking, she covered her mouth and began to cry.

The patient on the hospital bed was tortured by the pain, so naturally he didn't care to argue back with her.

"Now is not the time to talk about this, we must rush to treat patients."

Lin Yi said directly with a serious face.

Afterwards, he immediately turned his head to look at Wu Jiang, and ordered:

"Give him fasting and water first, so as not to increase the burden on the pancreas and aggravate his condition."

"Then give him pain relief, parenteral nutrition, and somatostatin."

"There is also the need to improve other inspections and find out all relevant indicators!"

After Lin Yi finished speaking, Wu Jiang immediately nodded and said:

"Well, okay, Brother Yi, I understand!"

………………

Early the next morning.

Lin Yi walked into the office, patted Wu Jiang on the shoulder and said:

"You worked the night shift all night, go back and rest, Yin Liang will be here in a while, just ask him to assist me."

Wu Jiang was checking the inspection report, and when Lin Yi slapped him, he suddenly raised his head and said to Lin Yi:
"Then what about you...... Didn't you stay up all night and not go back?"

"I'm fine, I have more energy."

Lin Yi smiled and said to him.

With the bonus of physical strength, I did not feel too sleepy or tired after surviving the night.

"OK then."

Wu Jiang looked at Lin Yi's face, and there was really no sign of fatigue.

And his own eyes were already red and bloodshot, after all, he had been busy all day the day before, and he couldn't take it anymore with the continuous work at night.

This brother Yi is simply an iron man!
He couldn't help sighing again in his heart.

Lin Yi looked at him in surprise, and thought that tonight he would not be able to work the night shift no matter what, not because his body couldn't bear it, but because he was afraid that they would treat him as a monster!

"Oh, by the way, Brother Yi, I was just about to tell you!"

Wu Jiang suddenly remembered, took the inspection report in his hand, and raised it towards Lin Yi,

"Look! The patient's blood lipids are abnormally elevated, and the triglycerides have reached 21mmol/L (the normal level is below 1.7 mmol/L), which is too high!"

"Let me see!"

When Lin Yi heard this, he immediately became nervous and hurried over.

After a while, Lin Yi kept nodding his head and said:

"I see! No wonder the patient developed such severe pancreatitis! From this point of view, overeating and drinking a lot of alcohol are only part of the reasons, and the main reason is that his triglyceride level is too high!"

"I really didn't expect this at the beginning. It turned out to be caused by two reasons."

"The main cause of acute pancreatitis is biliary stones, which can account for more than 50%."

"Then there are two causes of hyperlipidemia and overeating and drinking."

(End of this chapter)