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

After arranging him, Wu Jiang came to find him.

"Brother Yi, there is a female patient in the ward, go and have a look, there is something wrong."

Wu Jiang looked at Lin Yi and said.

"Can't you handle it?"

Lin Yi couldn't help asking.

"Well... it's a little difficult, let's go!"

Afterwards, Wu Jiang led Lin Yi to a ward.

In the ward, a young woman was lying on a hospital bed, looking sluggish.

Oxygen has been infused and a drip has been put on.

Wu Jiang pulled Lin Yi to the patient's bedside and said:
"The patient is 26 years old and lives in the suburbs. He reported dizziness, nausea, and palpitation after spraying pesticides in the field today."

"I did an electrocardiogram, but there was nothing wrong with it, but the cholinesterase decreased. I thought it was poisoning from pesticides absorbed through the skin."

Having said that, Wu Jiang paused, then frowned and said,

"The problem is that her blood counts of red blood cells and hemoglobin are relatively low, but pesticide poisoning can't explain the low blood count. But she has no other symptoms except dizziness, nausea, and palpitation."

Wu Jiang briefly explained the situation of the female patient.

Then look at Lin Yi to see what he has to say.

In the current weather, if you apply pesticides at noon, it is easy to cause poisoning from the pesticides absorbed through the skin.

And this female patient experienced dizziness, nausea, palpitation, and decreased cholinesterase after the application of pesticides at noon, which indicated that she might be poisoned by organophosphorus pesticides.

There is another key point that Wu Jiang can't figure out.

That is pesticide poisoning, which will not cause blood routine red blood cells and hemoglobin to drop!
How should this be explained?
The female patient looked in poor spirits and her complexion was a little pale.

After pondering for a moment, Lin Yi asked, "Did you ask her if she had her period?"

Wu Jiang nodded and said:

"I asked, her period has just passed a week."

"But she said that her menstrual flow is normal. The problem of low red blood cells and hemoglobin should not be caused by excessive menstruation."

The reason why this patient made Wu Jiang feel difficult.

It is because the patient applied pesticides at noon when he sweated the most, which could easily cause pesticide poisoning.

Moreover, her symptoms were only dizziness, nausea, and palpitation, which were also in line with the symptoms of pesticide poisoning.

But this female patient's anemia is very abnormal.

Pesticide poisoning will not cause anemia.

So these various situations made Wu Jiang a little clueless.

Lin Yi didn't speak, turned around and went to the nursing treatment room, and took a [-]ml syringe.

Seeing that Lin Yi brought back a syringe, Wu Jiang couldn't help being puzzled.

He couldn't figure out what Lin Yi was going to do?
Lin Yi first used iodophor to disinfect the patient's left lower abdomen and anti-Mabsonian point.

Then he said to the patient: "I'm going to perform a paracentesis on you now, don't be nervous."

The female patient nodded slightly.

Wu Jiang understood immediately.

"Lin Yi, do you suspect that she has an ectopic pregnancy? It's impossible, the menstruation has just passed."

Lin Yi smiled.

"Look it up, you'll know if you don't!"

As Lin Yi said, he performed a puncture on the patient's lower left abdomen.

As the syringe plunger was pulled out, dark red blood was drawn out of the syringe immediately.

Lin Yi drew about four or five milliliters, and then pulled out the syringe.

Shaking it against the light, the blood in the injection did not coagulate.

Wu Jiang was stunned immediately!
"The abdominal cavity is drawn out without clotting!"

"She actually had an ectopic pregnancy!"

There are a small amount of lubricant in the abdominal cavity of normal people.

But with a syringe, it is impossible to draw out blood, let alone draw out blood.

There is only one possibility that blood can be drawn from the abdominal cavity, that is, the patient has intra-abdominal hemorrhage.

However, this patient was not injured, so rupture of the liver or rupture of the spleen can be ruled out.

Then there is only one possibility, which is ectopic pregnancy.

Because the patient has an ectopic pregnancy, it is usually accompanied by menopause.

And this patient had just passed her period for a week, so she was ignored by Wu Jiang.

At this time, Wu Jiang saw the tube of blood that Lin Yi was holding, and he was secretly glad.

Fortunately, Lin Yi had a look at it, or else he didn't take this patient's anemia seriously.

Then the patient's ectopic pregnancy will continue to bleed, resulting in missed diagnosis, which will make her condition critical.

Wu Jiang glanced at Lin Yi gratefully, and wiped his sweat secretly.

Now the patient's condition is basically clear.

However, further examination is needed to complete the relevant evidence.

Lin Yi handed the drawn non-clotting blood to the nurse beside him, and said:
"Give her a color ultrasound of the uterine appendix, check blood HCG, make blood type and prepare blood, and prepare for surgery."

Wu Jiang immediately said:

"Okay, I'm going to do these tests on her now, and ask the family members to sign the consent form for the operation."

Surgical treatment is the only option for ectopic pregnancy.

What Lin Yi has to do now is to communicate with the family members as soon as possible and ask him to sign the consent form for the operation.

The family member who came with her was a young man, her husband.

Her husband became very nervous when he heard about the surgery.

"Doctor, what is an ectopic pregnancy? Why do you still need surgery?"

It is normal for ordinary people to not understand ectopic pregnancy.

Lin Yi patiently explained to him.

In this case, if he does not explain clearly to his family, he will not sign the consent form for surgery.

Talking before surgery is normal work.

Lin Yi stood beside the patient's bed and said to her husband:

"Ectopic pregnancy is an abnormal pregnancy process in which the fertilized egg implants and develops outside the uterine cavity. It means that the fertilized egg should have implanted and developed in the uterus, but it went to another place."

"The most common place for ectopic pregnancy is the fallopian tube. That is, the fertilized egg implants and develops in the fallopian tube."

"As the fertilized egg develops, the fallopian tubes rupture. Patients often experience abdominal pain, dizziness and shock."

"Your wife's situation is quite special. The abdominal pain is not obvious. The main reason is dizziness and palpitation. We need an operation now to remove the fallopian tube on the diseased side. If we don't do the operation, it will be life-threatening."

Lin Yi spoke in such detail, and directly informed the man of the dangers of the disease.

If he still disagrees with the operation, it means that he does not want his wife to live.

Hearing that the operation would kill him, the man nodded immediately.

"Agreed, I agree to the operation, doctor! Then please make arrangements to perform the operation on my wife."

"okay."

Lin Yi nodded and said to him again:
"There are two options for ectopic pregnancy surgery. I need to tell you which one you choose."

"Well, tell me."

The man nodded.