eurekapd Chapter 647
Chapter 647
Next, it's time to do a CT scan.
It has been determined that something as serious as "Hirschsprung disease" has been determined, and there are still more than 20 years, then naturally you cannot be reserved, use B ultrasound or something, but should directly use nuclear weapons CT!
"You go for a CT, and then you draw blood for a blood routine, electrolytes, etc..."
......
An hour later,
CT results feedback.
· CT shows that large amounts of excretion accumulate in the colon, blocking the intestinal lumen and causing extreme dilation of the local intestinal lumen (proximal to obstruction).
Determination of megacolon.
Lin Feng looked at the CT report.
Evaluated.
"The in this intestine should have more than 20 pounds, right?"
Lin Feng was surprised.
Xiao Ru was on the side, already shocked and incoherent!
This disease, needless to say, definitely requires surgery to cut off the megacolon.
"Dr. Lin... Do you want surgery? "
"Yes... To cut it off..."
Lin Feng looked at this patient young man with a pity on his face.
Just now he evaluated the patient's colon:
The total length of the colon, more than 70 cm.
The length of the megacolon is at least 50cm long.
Some of these 50cm are congenital megacolons.
In addition, at least half, more than 25cm, are acquired, and the reason for the formation is naturally the continuous accumulation of feces for 20 years, resulting in the intact intestinal segment being destroyed and becoming a new megacolon segment.
If this young man can cut off the section of the congenital megacolon (below 25cm) at birth, then he can save more than 25cm of healthy colon without cutting.
Now, he can only cut off 50 cm of the megacolon, leaving a healthy colon that is 70-50 = 20 cm long.
Such a short colon will naturally seriously affect the patient's later life.
(PS: There is also a disease called "congenital short colon".) ）
"Doctor Lin, is the operation difficult..."
"It's not difficult, but your giant colon is a bit long, and after cutting it off, the healthy colon will become a little short, which may affect life..."
"Huh?"
"But if you don't cut it, it's even more impossible..."
"Cut it then!"
The thought of 20 years of constipation makes the young lad a little impatient.
"It's not without good news... Your situation, not stained with colon cancer, is already good..."
"Ahhh..."
The young man couldn't help but rejoice again.
At this time, the results of the young man's blood routine, electrolytes and other results also came out.
It was indeed anemia, but it was not very serious.
But electrolytes don't.
"First hospitalization, anemia, electrolyte levels, nutritional status, etc., conditioning, and then go for surgery... Prepare for seven or eight days in the hospital before surgery... Let your family come and take care of you..."
Lin Feng opened the bill.
"Thank you Dr. Lin..."
The patient boy said gratefully.
......
......
Next patient,
It's a couple.
The husband took his wife in his arms and walked in.
The wife was pale and felt excessive blood loss.
The husband looked anxious: "Doctor Lin, help me see, my wife has been bleeding recently..."
Lin Feng: "What are you talking about bleeding?"
The husband was a little twisted.
The wife said generously: "It's Yin*..."
Lin Feng was surprised and asked, "Shouldn't you go to a gynecology department?" "
As a doctor, he doesn't mind, but patients should.
(In fact, gynecology comes to see a doctor, are very dirty (physical), for gynecologists, it looks very disgusting, see too much numb.) So don't think male doctors take advantage. Some obscene male doctors are not excluded. ）
The husband sighed and said, "I've been registered for a long time, I can't hang up at all, it's too difficult to register... I heard that Dr. Lin is very good at gynecology, so I came to you..."
Lin Feng nodded: "If you don't mind, I can help you see... Say, what's the situation? "
Husband, let's start, let's talk.
Here's the situation:
The patient's wife, 35 years old, had two caesarean sections and gave birth to two children.
And just half a month ago, she went to the hospital and found out that she was five weeks pregnant.
She didn't want to have children anymore, so doctors miscarried her with mifepistone.
After taking the medication, she successively developed "lower abdominal pain" and "shade passage" bleeding.
Miscarriage has been carried for half a month.
She bleed for half a month.
This would explain why she was pale.
"Anemia" caused by bleeding!!
"Miscarriage, huh?"
"Yes."
"The first two babies, is it a vaginal birth or a caesarean section?"
"The first child was born vaginally, and the second child was delivered by caesarean section."
"Is it the blood that came out after the miscarriage?"
"Yes."
Lin Feng nodded.
I probably have some judgment in my mind.
Gynecological bleeding is generally caused by:
Uterine fibroids (previously written)
Scar pregnancy: The uterus is scarred because of the last cesarean section, because the placenta is embedded in pregnancy, and when the placenta is miscarried, the placenta is peeled off, resulting in the tissue embedded in the scar part of the uterus being torn out, injuring the arterial vein, causing bleeding.
Yue Jing
Considering that the patient is bleeding continuously after the miscarriage, the cause can basically be determined to be "scar pregnancy"!
"Let's be a shade * B ultra... Then go for a blood routine..."
Lin Feng opened the bill.
This B ultrasound, naturally, is not done by Lin Feng, but let the female teacher on the side of B Chao help do it.
......
As a child,
B ultrasound results are returned.
Scar pregnancy!!
Moreover, behind the B ultrasound result, the B ultrasound teacher also said:
"(Suspected) the patient's scar pregnancy blood flow is abundant, and it can rupture at any time, causing heavy bleeding and life-threatening..."
So
Must be hospitalized and constantly observed!
And, be sure to have surgery!
And this kind of surgery is more difficult to do.
Lin Feng informed the patient's couple of his judgment.
The patient's husband and wife were surprised and uneasy when they heard this.
"Doctor Lin, what then?"
"Hospitalization, continuous observation, and then surgery..."
"Okay, okay."
Hurry up and check in for admission.
It can be seen from this patient.
For women with conditional vaginal delivery, it is best to choose vaginal delivery for the first birth, so that this dangerous "scar pregnancy" can be avoided.
And if the first child has been delivered by cesarean section, if you want to conceive a second child, you must pay attention when preparing for pregnancy!
After a caesarean section, it takes 3-5 years before considering another pregnancy.
Before giving birth to a second child, ask a doctor to evaluate yourself for a uterine scar.
After becoming pregnant with your second child, you should also pay attention to:
Every 6 to 7 weeks, ultrasound is done to see if the baby is implanted at the scar site (during pregnancy, it may happen that the placenta moves to the scar and penetrates deep into the uterus, resulting in an implantable placenta). ）
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