Anorectal department met first love, my agency died

Chapter 40
Xiao Yi was making breakfast at Song Shiwei's house when he received the call. When he heard the news, he quickly put down the sandwich in his hand, left a note for Song Shiwei and rushed to the hospital.

"What's the situation?" Xiao Yi asked.

Zhang Yuanyuan and Xiao Yi went to Li Chuchu's ward together, "Li Chuchu got up in the morning and wanted to have a bowel movement, but she pulled blood from the toilet, which scared her so much that she rang the bedside bell. You called."

Xiao Yi nodded, walked to Li Chuchu's bed and looked at her. Her face seemed to be fine, not like anemia, and her breathing was stable.

When the assistant saw Xiao Yi coming, he hurriedly pushed Li Chuchu and said, "Chuchu, Doctor Xiao is here."

Li Chuchu opened her eyes and saw Xiao Yi smiling weakly, "Doctor Xiao!"

"How do you feel now? Do you feel uncomfortable anywhere?" Xiao Yi asked.

"It's okay, it just hurts a little there." Li Chuchu shook his head, "I wanted to go to the toilet in the morning, so I didn't feel like I was exerting too much force. Who knew I had to urinate so much blood, it scared me to death."

"Has the toilet been flushed?" Xiao Yi asked Zhang Yuanyuan.

"No, I just wanted to wait for you to come over and take a look." Zhang Yuanyuan said.

Xiao Yi walked into the bathroom and saw that in addition to the original water in the toilet, the amount of bleeding was at least [-] milliliters.

Li Chuchu has mixed hemorrhoids, that is, there are internal hemorrhoids and external hemorrhoids.

Mixed hemorrhoidal stripping and ligation was used.It means to peel off the hemorrhoid blood vessels, ligate the blood vessels, and then cut out the hemorrhoid core.

It's just an ordinary surgery.

It is normal to have a small amount of bleeding after hemorrhoid surgery, but it is not normal to bleed so much.

Xiao Yi asked Zhang Yuanyuan to flush the toilet, then walked to Li Chuchu's side, lifted her quilt and looked, there was no sign of blood staining on her trousers, nor did the bed sheet, the blood should have stopped.

"You need a colonoscopy in this situation. There should be bleeding points, and the bleeding needs to be stopped." Xiao Yi said.

Li Chuchu nodded. Since it was like this, he naturally wanted to check it carefully.

So another enema was given and a colonoscopy was arranged.

Xiao Yi found that there was a small bleeding point in the wound of hemorrhoid surgery, and some blood came out from time to time.

But this bleeding point should not cause such a large amount of bleeding, so I pushed the endoscope in again and took a deeper look.

As a result, an obvious vascular malformation was found in the sigmoid colon, like a hemangioma, with a bleeding point on it that oozed blood from time to time.

Xiao Yi saw that the bleeding site was not too big, so he directly sprayed the blood coagulation drug on the bleeding point under the colonoscope, and then sewed another stitch on the bleeding point of the hemorrhoid wound.

After returning to the ward, Xiao Yi told Li Chuchu that he had discovered a hemangioma in her intestines and that he had temporarily stopped the bleeding.

"The bleeding stopped, won't it bleed again?" Li Chuchu asked.

Xiao Yi pondered for a moment, "We still need to observe. The hemangioma was only treated with coagulation drugs, but if the bleeding point increases, it may still bleed. You must pay close attention and notify me immediately if the amount of bleeding increases."

"Okay." Li Chuchu nodded.

The assistant also said hurriedly: "I will definitely pay attention."

Who knew that Li Chuchu bled twice again in the afternoon, and Xiao Yi hurried over.

"It should be the problem of the hemangioma. The coagulation medicine can't stop it. We need an operation to cut off the intestine with the hemangioma. Call your family members." Xiao Yi said.

The assistant was frightened when he heard it, and quickly called Li Chuchu's parents, and soon the two of them rushed to the hospital.

Xiao Yi told them about Li Chuchu's situation, and Li Chuchu's father asked, "Does the intestine have to be cut out too? Can't just cut out the hemangioma?"

They were mainly worried about whether cutting off a section of the intestine would affect their daughter's health.

Xiao Yi explained, "Hemangiomas are all blood vessels. It is difficult to stop the bleeding by cutting directly. It may cause severe bleeding. It is best to cut the relevant intestines together. It is easy to sew to stop the bleeding and the effect will be much better."

Li Chuchu's parents thought over and over again, but still felt that safety was more important, and agreed to the operation.

Xiao Yi then arranged another operation for the next day, this time a laparotomy, and laparotomy is the most intuitive.

Then the intestinal tube of the hemangioma was cut, and the incision was re-sewed up.

After the operation, Xiao Yi told Li Chuchu's parents that the hemangioma was removed and the intestinal tube was anastomotic. He had to fast for a period of time. The intestinal tube would slowly grow back and there should be no problem.

Li Chuchu's parents know that he is the deputy chief physician, and they are very relieved, thank you very much.

Unexpectedly, the next day, Li Chuchu bleeds again, and the amount of bleeding is still very large, several hundred milliliters.

It happened that Director Wang also came back, so Xiao Yi consulted with him.

It stands to reason that hemorrhoid surgery has also been done, and the hemangioma has also been removed, so why is there still bleeding? Could it be that the surgery was not done cleanly?

But Xiao Yi felt that what he did was absolutely fine, and Director Wang also believed in his medical skills.

Where is the problem?
The only option was a second laparotomy, but there were no problems with the last operation, and there was no visible bleeding on the surface.

So I did interventional hemostasis again, and I went to the interventional department to put the catheter into the blood vessel and create a contrast agent in the blood vessel.

If the blood vessel is bleeding, the contrast agent will leak out at that place, and the leaked contrast agent can be seen by taking X-rays, so as to deduce which blood vessel is bleeding.

After finding the blood vessel, the hemostatic coil was pushed into the hemostatic coil with a guide wire to stop the bleeding.

Everyone thought it would be fine now.

Who knew that Li Chuchu had blood in his stool again the next day, almost two hundred milliliters, and she was about to go into shock.

"Have your coagulation function been checked?" Director Wang asked with a frown.

Anorectal really rarely encounter such intractable diseases.

"I checked, and there is no coagulation disorder." Xiao Yi said.

General surgery only needs to do blood routine, as well as checks such as liver function, kidney function and syphilis.

But after Li Chuchu's first hemorrhage, he added the item of coagulation dysfunction, which should be taken into consideration, but there is no problem after checking.

Everyone fell into deep thought again.

"Is there hemophilia?" Xiao Yi asked.

Li Chuchu's parents were immediately called over. Generally speaking, hemophilia is a hereditary disease. If the parents have children, there is a certain probability that they will get it.

However, hemophilia is generally passed from male to female, and girls are less likely to get the disease.

Unless it's not hereditary, but acquired hemophilia, it's hard to say.

When I asked Li Chuchu's parents, it turned out that they did not, but the possibility that Li Chuchu had hemophilia could not be completely ruled out.

Xiao Yi called Li Chuchu's assistant over again.

"Will Li Chuchu bleed easily when brushing her teeth?"

"Yes, how do you know?" The assistant was surprised.

"Then does she get bruised easily if she bumps her hands and feet?"

"Yes, it often happens." The assistant nodded.

But they are usually used to it, so they don't think there is any problem.

Xiao Yi and Director Wang looked at each other, "It's really possible hemophilia, check it out!" Director Wang said.

After checking, it turned out that he really had hemophilia.

The main hemophilia is not very common, and it is not taken into account in general surgery, let alone it is not hereditary. It can only be said that Li Chuchu is too unlucky.

(End of this chapter)