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

Chapter 258 Can't find the bleeding point!
"What about next time? You may not be so lucky next time."

"So that's it! I didn't expect such a disease to exist? It's only after exercising that this kind of allergy will appear?
Ouch, this is the first time I have heard of it in my 40 years of life. "

The girl's father looked rejoiced.

Allergies are better than cancer tumors...

Lin Yi made another small science popularization for the family members:

"This disease is really rare, and the first case of food-dependent exercise allergy in our country was only discovered seven years ago.

The patient was also allergic but could not find the cause. After going to a large hospital many times, it was found out that it was the disease.

This disease is rare, so most people don't pay attention to it.

In addition to wheat, there are vegetables, shrimp, seafood, fruits and so on.

If you only eat these foods, there is actually no reaction, and very few patients may have mild reactions, or even so slight that they are not noticed at all.

Allergic reactions will only occur if you exercise after eating these foods.

Some allergic reactions are also mild, so don't pay attention to them.

Only serious cases like your daughter will be sent to the hospital. "

The family members nodded frequently, as if they had been educated.

"After the liquid is transfused, we will observe it upstairs for two days, and if there is nothing wrong, we can go back.

Don't worry, as long as the rescue comes back, it's not a big problem.

I'll ask her about her usual eating habits when she wakes up later. "

"Okay, thank you, doctor!"

The family members stood up while thanking.

After watching the family members leave the office.

Several doctors in the office gave Lin Yi thumbs up one after another!

After a while, an ambulance stopped steadily at the gate of the emergency department.

Emergency doctors and family members helped to send the girl to the emergency room.

As soon as he came in, he could see that the girl was already pale and sweating.

"When did you start losing blood? You're already close to shock??" Wu Jiang looked at the emergency doctor and asked.

The emergency doctor shook his head: "We don't know, we only know that we have taken diet pills for the past few days, and the family members said that they have had a little bit of blood in their stools for the past few days, and then they just had blood when they went to the toilet at home.

Both the pants and the sofa were stained with blood, I don't know what happened. "

Wu Jiang frowned: "Blood in the stool? It's not vaginal bleeding but lower gastrointestinal bleeding??"

The family members on the side nodded again and again:
"Yes, our daughter is single. She is not pregnant and cannot have cervical cancer. She is bleeding in the stool."

Upon hearing this, Wu Jiang nodded and said:
"Okay, let's expand her blood volume first. Her current state does not rule out the possibility of hemorrhagic shock. Your family members should also be mentally prepared."

The family members burst into tears when they heard this!

"Doctor, my daughter is only 24 years old, please help me, save her!"

"Don't worry, we will definitely try our best to save you, please don't panic."

Soon, the female patient was connected to various monitoring instruments.

Includes drugs that expand blood volume.

Blood pressure 88/60mmhg, respiration 26 beats/min, heart rate 128 beats/min.

Various indicators seem to have the possibility of shock.

Just in case, Wu Jiang hurriedly asked the nurse to prepare blood plasma.

"Xiao Zhao? Can you hear me?"

The patient on the hospital bed is very weak and breathing rapidly.

But she was still conscious. Hearing Wu Jiang's question, she nodded slightly.

"Do you know how many times you have pulled blood yourself?"

"No... I don't know... It seems to be many times... Anyway, I have been uncomfortable these few days."

"Are you sure it's not lower body bleeding but blood in the stool?"

Wu Jiang asked again.

For female patients with lower body bleeding, it is necessary to accurately distinguish whether it is from the digestive tract or vagina.

Otherwise it is easy to misdiagnose.

Asked by Wu Jiang, the girl actually thought about it.

Wu Jiang thought to herself, she doesn't even know this, does she?

After waiting for a while, she said, "It's...it's...blood in the stool, and...it's the kind that pulls blood."

Pull blood? ?
It wasn't until Wu Jiang heard that the patient confirmed that it was bleeding, that it was not good.

The blood was pulled directly, wouldn't it be a tumor in the intestine?Or a ruptured intestinal artery? ?

The digestive tract of normal people is divided into upper and lower sections.

The upper gastrointestinal tract mainly starts from the mouth, then goes to the esophagus, stomach, duodenum and part of the jejunum.

The lower gastrointestinal tract begins with part of the jejunum, followed by the ileum, colon, and rectum.

The stomach or esophagus is the most common point of upper gastrointestinal bleeding.

Black stools, not bloody stools, occur when upper GI bleeding occurs.

The lower gastrointestinal bleeding will directly be bloody stools, that is, bright red blood.

Why is this.

Because after upper gastrointestinal bleeding, it can only be discharged after going through a round of digestion in the intestinal tract.

At this time, the blood has been digested several times by the intestines, and it is no longer the freshest blood.

As for lower gastrointestinal bleeding, that is, colon or rectal bleeding, it is very close to the anus, which is the discharge port, and it will soon flow to the anus as soon as the bleeding occurs.

Therefore, bright red blood can be directly seen in lower gastrointestinal bleeding.

At present, the female patient has personally admitted that she has bloody stools, which means that it is very likely that there is a problem with the lower gastrointestinal tract.

While Wu Jiang was thinking about preparing for a physical examination.

The nurse suddenly called softly:
"Doctor Wu, it's bleeding, a lot of blood!"

The nurse was giving the patient an injection to prepare for the infusion.

result! !
As soon as the quilt was opened, it was found that the sheet under the girl's buttocks had been dyed red!

Wu Jiang was taken aback for a moment, and strode up.

When even a shocking red came into view.

The nurses frowned, looking surprised.

This is the first time they have seen each other.

So I can only watch Wu Jiang operate.

"Hurry up, quickly establish a vein channel, expand the blood plasma first, and transfuse blood immediately after the blood type result comes out!"

"it is good!"

Seeing that the patient had lost so much blood, the nurse did not dare to delay, and moved much faster.

At this time, Wu Jiang didn't have time to think about it, so he pulled the curtain beside the bed and prepared to take off his pants for inspection with gloves on.

The girl was still a little conscious, and subconsciously pulled her pants.

"I...I..." The girl glanced at Wu Jiang, a little shy.

Wu Jiang knew what this girl was struggling with.

Women who have never been married are somewhat embarrassed when facing male doctors, especially male doctors who want to check their private parts.

"Don't worry, I will protect your privacy. Don't treat me as a male doctor, just as someone who can save your life."

Hearing this sentence, the woman let go of her hand slightly.

She lost so much blood that she gradually lost her strength.

I even started to feel dizzy and confused.

What happened next, the patient had no idea.

Wu Jiang quickly took off his pants and saw that the patient's entire lower body was stained red with blood.

"Wang Qiaoya, what are you still doing? Come and help me!"

"Oh, here we come!"

Wang Qiaoya nodded, and immediately helped Wu Jiang check with gloves on.

"Bring the cotton pad!"

Cotton pads can be used to insulate blood on the sheets, which are similar to sanitary napkins.

"gauze!"

Wu Jiang first wiped the entire lower body of the patient with gauze.

It was found that the blood did not flow out from the penis, but from the anus.

Just after wiping it with gauze, a trace of blood flowed out of the folds of the anus.

Wu Jiang touched it with his index finger, but found no hemorrhoids.

(Hemorrhoids can also have blood in the stool)

"This situation is a bit serious. If you don't find the bleeding point immediately, it will be useless to transfuse more plasma and blood."

"Wang Qiaoya, take off the patient's pants and give them to the family members, and then put the patient into clean and loose patient pants."

After Wu Jiang finished speaking, he went out to make a phone call.

I have to contact the doctor in the colonoscopy department as soon as possible, and this patient has to jump in line for an urgent investigation.

Now it has been confirmed that it is lower gastrointestinal bleeding, otherwise the blood would not be so bright red or flow so fast.

After a while, the colonoscopy department came to inform that there was room for the emergency department to do it immediately.

Wu Jiang immediately led the people there.

Colonoscopy room.

The patient is undergoing examination while being transfused with plasma.

The colonoscope was inserted from the anus into the rectum, and no bleeding point was found all the way up to the jejunum? ?

The doctor who performed the colonoscopy and Wu Jiang were a little puzzled.

"Let's read it again and rinse it more." Wu Jiang said.

The flushing tube went in, and after repeated flushing several times, I looked at it again with a colonoscope.

But here is the problem.

This second time, there is still no bleeding point? ?

Seeing the tangled expressions of the doctors, the family members asked anxiously:

"Doctor, what's the matter with my daughter?... What's the matter with her?"

The family members burst into tears.

Wu Jiang quickly comforted:
"Don't worry, we are still checking, please don't worry."

In the lens display screen, inside the pink intestine, let the lens turn around, and he couldn't find the bleeding point.

"Strange, isn't the bleeding point in the lower digestive tract?"

The colonoscopist also frowned slightly and said:
"It's possible. Why don't you add a gastroscope? After so long, there is no problem with the colonoscopy, so I can only look at the gastroscope."

Wu Jiang could only turn around and say to his family members:

"Although your daughter has blood in the stool, we haven't seen the bleeding point after the colonoscopy, so we can only do another gastroscopy to see if the bleeding point is in the upper digestive tract."

"Okay, do it, do it, we will do it all, as long as it can save my daughter, I will do it!"

The family members nodded while crying.

"Don't worry, at this juncture, we will never cheat you for the examination fee. If you don't find and stop the bleeding point as soon as possible, your daughter will be useless no matter how much blood is transfused, understand?"

The family members nodded, and then one went to pay the fee, and the other took the patient to the gastroscopy room.

Gastric lavage first, and a gastroscopy immediately after washing.

As a result, the gastroscopy still did not see the bleeding point!
Not even a single ulcer or polyp was found!
"What's the situation?? Why didn't you find it?"

The doctor who performed the gastroscopy slowly pulled the lens from the front of the jejunum to the mouth.

Still not found!
It's wicked!
What the hell? ?
Didn't see the bleeding point, but the anus is bleeding? ?
It simply made Wu Jiang and the doctor who performed the gastroscopy puzzled!
Without finding the reason, Wu Jiang could only take him back to the emergency room.

But the problem of bleeding points must be resolved as soon as possible.

Otherwise it's a ticking time bomb.

Soon the result of the blood type came out, it was type B blood, and the blood bank sent 400ml of whole blood immediately.

Once the blood was transfused, the patient's complexion improved a lot.

Just when everyone could breathe a sigh of relief, the bed sheet was lifted, and there was another puddle of blood!

Wu Jiang is also in a hurry at the moment, sweating a little on his brow.

This time, Lin Yi, the boss of the emergency department, went up for surgery, so he could only rely on himself here.

The emotions of the family members who could not find the bleeding point became more and more agitated.

I've been doing this check and that check for a long time, but it just doesn't work!

Wu Jiang resisted the pressure, and after thinking for a while, he continued to order:
"Contact the bedside color Doppler ultrasound again, and the doctor in the interventional department will also inform you to come over for consultation."

I came here because I wanted to see if ultrasound technology could be used to find bleeding points in the abdomen and the entire intestine.

It is the last resort to ask the interventional department to come for consultation.

If you can't even find the bleeding point with color Doppler ultrasound, you can only do interventional examination, and you have to go to the operating room.

A contrast agent is injected, and with the help of radiation, it can be seen which blood vessel is leaking.

This is an invasive examination, and you will choose to do it if you are really dying.

"Let the blood bank bring over another two hundred milliliters of blood."

On the patient's side, if the blood cannot be stopped, blood transfusion must be continued until the bleeding point is found.

Otherwise, life will not be saved.

Soon, the color Doppler ultrasound doctor came first.

A search of the abdomen and the entire bowel found nothing.

But found another problem.

Is it this young female patient who still has stones?
Common bile duct stones, the location of the stones is still very close to the root of the pancreas.

Both the bile duct and pancreatic duct were slightly dilated.

However, the stone is still very small, only 0.3 cm, which is a relatively stable stone.

So Wu Jiang just glanced at it and put it aside.

The relationship between stones and gastrointestinal bleeding is not great.

Color Doppler ultrasound doesn't work... Then try enhanced CT? ?
The family members looked cold and wanted to get angry, but they agreed because of their daughter's condition.

Soon the CT results came out, and there was no bleeding point in the whole abdomen except stones.

This made Wu Jiang completely helpless.

"I can only find the interventional department."

It's just that this inspection is more expensive than other color ultrasound gastroscopes.

After all, it is a project that needs to be inspected while doing X-rays.

When the family members heard this, they couldn't help but explode!

"You have such a big hospital, you can't check for half a day without any results! Our money can't be wasted, right?!
Gastroscopy colonoscopy, B-ultrasound CT all done!Why is there no effect at all!
Aren't you taking people's lives for money? !My daughter is like this, why don't you hurry up and find out the cause? !"

Facing the anger of his family members, Wu Jiang could only bear it silently.

Sometimes doctors are not everything.

They don't have clairvoyant eyes, so it's impossible to find out the cause of the disease right away.

Especially thinking about the current patient who is bleeding for unknown reasons.

There is still a lot of bleeding. According to common sense, Wu Jiang's thinking is correct, and the lower gastrointestinal bleeding is indeed the priority.

But this girl seems to be out of line with common sense.

All these possible checks have been done, but I just can't figure out the reason.

Sometimes finding the cause of the disease is like investigating a case. It takes a little bit of unraveling to find out the 'murderer' without letting go of every detail.

(End of this chapter)