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

Lin Yi wrote down the main complaint in the outpatient medical record.

"Left chest pain for half an hour."

The woman is so young, and the part she is covering is the left midaxillary line, not the chest.

In this way, the possibility of heart disease is not great.

"Is she injured?"

"No, no, it was about half an hour ago."

"My wife coughed twice without warning, and then suddenly developed pain in the left chest, which was so severe that she dared not move now."

The man immediately said to Lin Yi.

Lin Yi frowned slightly after hearing this.

After coughing, there was chest pain on the left side, and there was no history of trauma.

Is it a spontaneous pneumothorax?
Some patients, if they suffer from lung diseases, especially those with bullae, may rupture the bullae after a severe cough, resulting in spontaneous pneumothorax.

Severe chest pain can also occur, but it is often accompanied by chest tightness.

"Apart from chest pain on the left side, do you feel stuffy now?"

Lin Yi stood up and came to the patient to give her a physical examination.

"Doctor, I don't have chest tightness, it's just pain, it hurts so much."

The woman finally spoke, but she felt out of breath.

Lin Yi knew that her situation was not caused by chest tightness, but because she dared not speak continuously because of severe chest pain.

After checking her chest, it was found that the woman refused to press on the midaxillary line of the fifth rib on the left side, and felt severe pain when touched.

Lin Yi already had a judgment on the woman's condition in his heart.

Back in front of the computer, I briefly wrote out the outpatient medical records, and then issued a checklist.

"I suspect you have a broken rib, go and take a CT scan."

Her husband was a little surprised after hearing this, and then asked in disbelief:

"Doctor, my wife has just had a cold and inflammation for the past ten days. We have had infusions in the small clinic downstairs for ten days, and now she is slowly recovering."

"She had a worse cough a while ago, and it was the chest pain that only appeared after two coughs today."

"She wasn't injured, how could she have a broken rib?"

"Why don't you prescribe some painkillers? I think it's still an inflammation problem. Let's go back to the small clinic for infusion."

Lin Yi looked at the woman's thin figure, and asked her:
"You are so thin, are you born thin, or is it caused by weight loss?"

Speaking of this topic, the man's emotions suddenly became a little excited:
"Doctor, I'm only angry when you say this. My wife is 1.6 meters 110 tall, and her weight has always been more than [-] kilograms before. In fact, this body is just right."

"As a result, in the past two years, she didn't know where she listened to the folk prescription for weight loss. She didn't eat much every day, and only took a few bites at each meal. I was anxious to ask her to eat more."

"As a result, in the past year, I have become so thin, and my weight is only more than 90 catties."

"I think her cold means that her resistance to weight loss has dropped. If it's the same as before, she won't have a cold and need an infusion."

Lin Yi nodded and said:
"You are right, this is excessive weight loss, resulting in weight loss and reduced immunity."

"Look at her upper body, there is almost no fat. To put it bluntly, it is almost like ribs."

"Her bone quality has also been greatly affected, and this time she had a cold, she had been coughing violently for more than ten days, and coughing twice half an hour ago was an inducement for fractures."

"Generally speaking, at your age, the chances of a cough causing a bone fracture are extremely low."

"Usually, it is the elderly who have osteoporosis. After severe coughing, fractures will occur."

"But now you have limited tenderness on the left side, and the pain is severe, so the possibility of rib fracture cannot be ruled out."

"It's best to take a CT film to give you a clear diagnosis and then treat the symptoms."

"If you don't have a clear inspection, simply prescribing you painkillers will violate the principle, and it will not solve the problem."

Hearing Lin Yi's detailed explanation, the woman thought about you, hesitated and said:

"Then I'll go check it out."

Half an hour later, the man helped the woman and slowly moved into the consulting room.

Pass the film in his hand to Lin Yi.

The man said:

"Doctor, look at the results of my wife's examination. Is there a fracture?"

Lin Yi took the CT film and put it on the viewing light. After looking at it carefully for a while, he pointed to a part on the film and said to the woman:
"Did you see it? This is the mid-axillary position of the fifth rib, and the rib cortex is discontinuous, which is a sign of a fracture."

"Your severe left chest pain now is due to the rib fracture caused by coughing. You may have never heard of how coughing can cause rib fractures, but it is happening to you now."

Lin Yi glanced at her husband, and continued:
"It stands to reason that it is almost impossible for you to cough a few times at your age and cause a fracture."

"The specific reason, I have explained to you just now, is because you are too thin and your resistance is weak, and excessive weight loss is an inducement."

"It is recommended that you eat normally in the future, and do not go on a diet deliberately to achieve the goal of losing weight.

"If you only rely on diet to lose weight, you may lose weight temporarily, but the harm to your body is much greater than the few pounds you lost."

The woman did not speak.

She has now clearly realized the disadvantages of going on a diet to lose weight.

After all, before she went on a diet to lose weight, she became more plump and not fat.

Before that, I didn't know what a cough and cold were.

But since I went on a diet to lose weight a year ago, I feel physically weak, occasionally dizzy, and mentally poor.

And get a cold and cough.

But this time the cold was even worse, and I had been infused directly at the community health service station for more than ten days, but it still hasn't fully recovered.

What's more frightening is that because of losing weight, I coughed twice and broke my ribs, which is really unbelievable!
It also completely frightened her.

The woman decided to eat and drink in the future, and she resolutely stopped talking about dieting and losing weight.

After all, life is important!

Seeing his wife, it was really a broken rib, and the man was a little nervous.

"Doctor, quickly go through the hospitalization procedures for us and perform an operation. She is in such pain that it affects her life now."

Lin Yi waved his hand and denied:

"Your lover only has a broken rib, and it hasn't been dislocated, nor has hemothorax or pneumothorax, so he doesn't need to be hospitalized."

"You just need to rest at home. It is recommended to take a leave of absence for more than a month to rest, and wait for the fracture to heal slowly.

"I prescribed a chest belt for her, wrapping her breasts will reduce the pain, and then prescribed some painkillers, which can be taken when the pain is severe, and the symptoms can be relieved."