Come on, Dr. Wu

Chapter 93 Pancreatitis (first order requested)
  Chief Wang walked into the demonstration classroom and spoke directly without any hesitation.

Wu Xiaofu looked at Wang Xuehai in front of him and couldn't help but sigh in his heart, this is also a nuclear-powered donkey. Last night's night shift, the one with cerebral hemorrhage, Wang Xuehai followed him for a whole night of surgery. The next day seemed to be even busier than last night. After they finished the exam, it was probably another day of surgery.

However, this is also the current situation of surgeons. Just go to the director. The director does not have to work the night shift. He can come when there is an operation. If there is no operation, there is no phone, so you can have a good sleep. As for the attending doctor, it is the time to work. , twenty-four hours, thirty-six hours, forty-eight hours, that is the norm.

It's not easy to schedule an operation. No matter what shift you work on, you can't run away when your patient is undergoing surgery.

It's just that forty minutes is a bit cruel to them.

Especially after the paper was handed out, Wu Xiaofu felt even more cruel. One hour and forty minutes for this paper was not too much.

"Hey, why are you still grabbing the pen?"

Just as Wu Xiaofu was about to take the pen, he found that his pen had been taken away. He looked at Qu Ying beside him and found that Qu Ying had a look of bitterness and hatred on his face. He didn't know whether it was towards him or the paper. When Wu Xiaofu heard that If so, Qu Ying gave Wu Xiaofu a look that could only be understood but not explained.

"My pen is returned to its original owner."

This girl is probably a relative here, she has a volatile temper.

He took out a pen from his pocket. Hey, it belongs to Qu Ying. Remember, you can have several pens in your pocket, but only one can be put out in the open, so that when others want to borrow it, you can say , I only have one, and it is useful, although it is not very useful. After all, your pen is gone when you are talking.

There are no multiple-choice questions, only fill-in-the-blank questions and short-answer questions, full of pros and cons. With this amount of questions, you can write directly without thinking, without pausing in the middle, and it depends on your writing speed for forty minutes. This is really terrible.

At this time, no one dared to delay anymore and hurriedly started answering the questions.

The questions are very complicated. Ten people took a set of papers. It does not mean that if you are a general surgeon, you will be given general surgery questions, and if you are special, you will be given special questions. It is a set of questions, including clinical disease analysis, pathology and immunity. , as well as humanistic care, and the topic covers the entire medical and surgical field. It is really terrible. Wu Xiaofu has a headache just looking at it.

If you see unfamiliar questions, just skip them. Answer the familiar questions first, and then come back to answer them when you have time. At this time, you must not hesitate.

When he was in college, there was a course called Military Theory. Wu Xiaofu still remembered it deeply. The final exam was an open-book exam. What Wu Xiaofu thought at the time was an open-book exam. It could be passed without any skills. But in the second half of the semester, , Wu Xiaofu is the one who knows the dangers of this open-book exam. He can't finish the answers, he can't finish them at all. The bell rings at the end, and there are many multiple-choice questions.

What made Wu Xiaofu most desperate was that the remaining questions were all multiple-choice questions.

The mood at that time, oh, a lot of bitter tears. Fortunately, I was sixty years old at that time. I don’t know if the teacher was scratching his head for him. From then on, Wu Xiaofu became more concerned. He read the questions first and looked at the familiar ones. , no matter what, you have to score sixty points on your own paper first, and then talk about the rest later.

Don't tell me, the efficiency of answering questions is just different.

"Okay, stop writing."

Without any reminder five minutes or a few minutes in advance, he just collected the papers. Wu Xiaofu put down the last stroke. Fortunately, it was all filled up. As for whether it was correct or not, that is another matter. Anyway, the papers should be allocated.

Moreover, he felt that he was justified.

Most of them had bitter faces, and they seemed to have been poisoned. This exam was probably the first time they had experienced it in more than twenty years. They were too tired and rushed.

Emergency Department.

Wu Xiaofu was getting ready to change clothes and leave. Today's exam and the outpatient clinic in the morning have been cancelled. After a busy night yesterday, Wu Xiaofu just went back to take a rest.

"Doctor Wu, you haven't left yet. There happens to be a patient. Please help take care of him."

Um! Looking at the stunned young nurse in front of him, Wu Xiaofu said that if she were in a palace drama, she would definitely not survive three episodes. No, it would be difficult to survive even one episode. She is too unsightly and ready to leave. She said that, how could Wu Xiaofu leave?

Looking at the flat car, the patient was a young man in his twenties. His face was pale, and his face was extremely distorted. It was obvious that he was exploding in pain.

"My stomach hurts. It's been three days."

The doctor following the car explained that Wu Xiaofu was even more speechless. This was an internal disease. "Send him to the emergency room."

"The day before yesterday at the company party, Xiaoyu started to feel uncomfortable in his stomach that night and vomited several times. At that time, he thought it was because of drinking. After vomiting, he would be fine. He didn't care. He thought of taking a nap and then vomiting. Okay, who would have thought that the next day, my stomach would be even more uncomfortable, painful and bloated, and I thought it was due to drinking.

After drinking some millet porridge to stay alive, I still insisted on going to work today. At about nine o'clock, I collapsed and was in so much pain that I couldn't stand still. We hurriedly sent him over. "

The person who sent the patient here was his colleague. Today, the internal medicine team happened to be Qiu Ying's day shift. Wu Xiaofu was not in a hurry to leave, so he just watched from the side. Qu Ying was also there, just to find out what was going on with this girl today. "Xiao Fu, Qu Ying, take a look."

Qiu Ying looked at Wu Xiaofu standing next to her and said that she seemed to have been poisoned by yesterday's mango this morning. The patients were coming one after another, and it was too busy for them. Since Wu Xiaofu and Qu Ying were here, she could simply let them go. They looked first.

"It's probably pancreatitis."

It was unclear whether the pancreatic problem was a medical or surgical problem. Wu Xiaofu felt that he could still learn something about it. The difference between internal and external diseases was nothing more than whether surgery was needed.

Overeating and drinking a lot, combined with the symptoms of pain, vomiting and distension, and no other medical history before, pancreatitis is the closest thing.

Wu Xiaofu went forward for a physical examination and found pain throughout the entire abdomen, especially in the left upper abdomen, with obvious tenderness and rebound pain. Peritonitis could not be ruled out.

It may not be mild pancreatitis.

Pancreatitis can really be a serious or minor disease. In mild cases of pancreatitis, you can usually recover without drinking water and taking medication for a period of time. But if it is severe pancreatitis, you are really on the road to death. It depends on whether the doctor can cure it. The gate of hell is closed to prevent you from entering.

The bowel sounds are weakened and there is gas accumulation in the abdomen.

I did an electrocardiogram, and the heart rate was 120. Everything else was fine, which could rule out heart problems. As for the heart rate, it hurt so much, and 120 was too normal.

"First draw blood, perform routine blood tests, biochemistry, and blood amylase, and then do a CT scan to focus on pancreatic problems."

In fact, in the emergency department, experienced doctors can basically tell what the disease is after seeing the patient's main complaint and doing a physical examination. But now that the machines are so good, all relevant examinations can be done, which can not only help diagnose the disease, but also check the condition. In serious cases, it can also be used as a reference for the subsequent course of the disease. Of course, this is the purpose of these auxiliary examinations in the first place.

I don’t know when later, it started to change. Instead, it became a tool for doctors to protect themselves.

At the beginning, I opened it as little as possible, but now I open it as much as I can think of.

"Did you drink less that day?"

Wu Xiaofu looked at the colleague who was sending the patient and asked. Qu Ying saw that Wu Xiaofu was already in a good state and had found the rhythm of previous cooperation, so she went directly to perform examinations and administer medicine.

"Not much, just a little. It looked like eight or nine bottles of beer. He couldn't drink liquor, so he had to raise a glass with the leader. There was no other way, so he drank a little while surviving. It was probably only two or three taels."

Well, that's true.

However, if you drink this beer and liquor together, you might as well just drink half a kilogram of liquor and get yourself drunk.

Beer contains a lot of carbon dioxide, which is why you burp after drinking too much. It also makes your stomach bloated easily. Carbon dioxide is not a problem, but if you drink liquor, the carbon dioxide will dissolve and form carbonic acid, which will stimulate the gastrointestinal tract and promote gastrointestinal function. Absorption of alcohol not only makes you drunk quickly, but also increases the burden on the stomach and liver, causing even greater harm.

The main role of the pancreas in this process is to help digestion. The pancreas secretes some enzymes such as amylase and lipase. The amount of food everyone eats every day basically forms a law, and the pancreas will also Get used to this law and secrete amylase and lipase regularly, but if you overeat, it is easy to catch the pancreas off guard. There are many enemies, and your ammunition has to keep up.

Moreover, the pancreas does not know exactly how much pancreatic enzyme is needed for your surprise attack, so it can only work hard. Pancreatic enzyme is secreted in large quantities, and the pressure in the pancreatic duct suddenly increases. This duct is so big, and too much stuff comes out. It is easy to get blocked. The digestive ability of pancreatic enzymes is not generally strong. Food is digested first when there is food. If there is no food, the pancreas is not unable to cope with it.

Yes, when the pancreatic enzymes are so strong that they even dry out the pancreas, the pancreas is attacked and damaged, which is pancreatitis.

What's more, the patient in front of me not only overeats but also drinks a lot, which is even more fatal.

Pancreatitis is still worthy of attention, so this CT must be done as soon as possible. The privilege of emergency department is also reflected here. The CT room of the First Affiliated Hospital is extremely busy. If you can lie down in the machine and look, you can find out. The machine was spinning and smoking, so appointments were usually made on the same day and done two or three days later, or even later.

Emergency patients can't afford to wait, so they have to jump in line.

Help, other patients can also understand. Anyway, other patients who have appointments have to be finished on this day, even if the CT room works overtime, so there is no reason why they can't do it today because someone jumped in the queue. Of course, there are exceptions. If the machine breaks down, no one can do anything and can only wait for the machine.

Wu Xiaofu followed him into the CT room and saw the CT results immediately.

Facts have proved that his judgment was correct. There was obvious edema around the pancreas and blurred borders, which were typical CT findings of acute pancreatitis.

After returning to the emergency room and seeing the amylase results, I was even more certain. The amylase level was over 900, while the normal level was 150. Now there was no doubt.

(End of this chapter)