In front of Zhou Shengsheng's eyes, the black panel with a full sense of technology appeared.
The patient's various physiological indicators are clear.
Age: 18 years and 215 days.
Height: 187cm.
Weight: 68kg.
Heart rate: 103 beats/min.
Blood pressure: 156/105mmhg.
Alcohol content: 85mg/100ml.
Current symptoms: compressive chest pain, difficulty breathing.
…
Zhou Yisheng scanned these data, and the most important thing was that Zhou Yisheng had to look at the causes of disease given by the system.
Zhou Sheng continues reading below.
…
Condition: pneumomediastinum
Cause: Spontaneous esophageal rupture. Severe vomiting after drinking alcohol and a heavy meal. Due to the pressure difference between the inside and outside of the esophageal wall caused by the negative pressure in the chest, the muscle layer of the lower esophageal wall is torn.
It turned out to be this disease.
Zhou Sheng suddenly realized.
Spontaneous esophageal rupture refers to the sudden full-thickness esophageal rupture in healthy people. Because most of them occur after drinking alcohol and vomiting, some people call it post-vomiting esophageal rupture.
This disease is relatively rare clinically. It was first described by the Dutch doctor Herman Boerhaave in 1724, so it is also called Boerhaave syndrome. The patient was an admiral who suffered esophageal rupture after overeating and vomiting. This disease
More common in young men.
As for why general vomiting can cause spontaneous esophageal rupture, there is no definite explanation under modern medical knowledge.
This condition is a very rare clinical problem.
According to relevant statistics, there is only 1 case in every 75,000 hospitalized patients.
Because it is so uncommon, the misdiagnosis rate can be as high as 80%.
Take a large tertiary hospital like the Central Hospital as an example, it may not encounter even one case a year.
The clinical fatality rate of this disease is more than 10%, and with the delay in diagnosis, the fatality rate will gradually increase.
The best solution to this disease is surgical intervention
In addition to exhausting the pneumomediastinum caused by esophageal rupture, the chest cavity must be drained. If the esophageal rupture is large, surgery must be performed to repair the esophagus.
It was clear that it was this disease.
Zhou Sheng already knew how to check.
Bai Mingming and Liu Zhengqing just suspected that the patient had acute pancreatitis, so they proposed the identification of upper abdominal color ultrasound and urinary amylase.
This is completely useless for the determination of spontaneous esophageal rupture.
The site of disease is in the esophagus.
The main symptoms are in the chest. A chest CT scan will immediately identify the problem.
Of course, Zhou Yisheng could not directly state the judgment given by the system.
It is still necessary to carry out inspections step by step.
However, Zhou Shengsheng can use his influence to move the inspection in the right direction faster.
Zhou Shengsheng made a decision immediately: "In addition to the abdominal color ultrasound, let's do a chest CT."
Bai Mingming thought that Zhou Yisheng did a chest CT scan to see if the patient had the possibility of pneumothorax.
So he said: "Team Leader Zhou, Dr. Liu and I have heard about his lungs just now. There is nothing wrong with it. The possibility of spontaneous pneumothorax is unlikely."
Zhou Shengsheng insisted: "After all, we have done so many tests, and one more test is not much. Since it is chest pain, let's have a good chest check."
Having said this, Zhou Sheng looked at the clock on the wall and continued: "There are fewer people doing inspections at night. It is estimated that after the inspection, we haven't gotten off work yet."
Liu Zhengqing suddenly said: "After so many tests, the cause of the disease has not been found. Will the family members have any opinions at that time?"
Zhou Sheng said: "Human lives are at stake, and the family members will definitely understand. I will be responsible for explaining the situation to them."
Zhou Sheng is no longer a little intern.
In terms of status, he is the leader of the fourth group.
If there is a dispute with the emergency department head of this group, you have to listen to him.
Moreover, Zhou Yisheng's skills are obvious to everyone, and he also has prestige.
So Bai Mingming and Liu Zhengqing didn't talk any more.
Three tests will be launched immediately.
The nurse begins to prepare the wheelchair.
At this time, Zhou Yisheng fulfilled what he had just said.
He walked to the door of the emergency room.
The boy's parents, who were waiting at the door, saw the doctor coming out and immediately cheered and surrounded him.
The two of them started asking questions.
"Has the cause of my son's illness been found?" the boy's father asked anxiously.
"Not yet, but after he comes out soon, he will do a few more tests, and I think the results will be available soon," Zhou Sheng said.
"I still need to do a check-up. Are you okay? It's been more than an hour. I just had two checks, and now I have to do another check-up. Besides the check-up, what else do you do?" the boy's mother said dissatisfied.
"Please understand. His condition is quite special. But I guarantee that after this examination, there will be results." With the help of the system, Zhou Yisheng is naturally full of confidence.
Doctors' confidence is sometimes the most important signal to patients and their families.
The boy's parents asked Bai Mingming the same question just now.
Bai Mingming's answer was obviously evasive.
The attitude is very unclear.
But the doctor who came later seemed to be confident.
The boy's parents felt relieved.
Subconsciously, they believed that Zhou Sheng must be a more powerful doctor who could diagnose their son's disease.
Of course, this is not because they are familiar with Zhou Sheng, but because Zhou Sheng gives them hope.
Talking room.
The boy was sitting in a wheelchair and was pushed out by the nurse for examination.
His parents no longer had time to pester Zhou Sheng, but followed the nurse's footsteps and went together.
…
An hour later.
Twelve o'clock midnight.
It’s time for the four groups to get off work.
Liu Jing, Li Weiwei, Su Quan and others went home from get off work.
In the emergency room.
Zhou Sheng, Bai Mingming, Liu Zhengqing, and Cao Xin haven't left yet.
They were waiting for the boy to come back from inspection.
Bai Mingming looked at the time and said: "Team Leader Zhou, Team Leader Liu, it's time to get off work, you go ahead. I'll just stay here. One group has also gone to work. If nothing can be done, I'll go
Find Wu Jianxing and Sun Zheng."
Naturally, I will not leave if I am born on Monday.
Spontaneous esophageal rupture.
For such a rare case, if the report came soon, he would not trust others to handle it.
I won’t leave, but others...
Zhou Sheng looked at Cao Xin and said, "Cao Xin, why don't you leave first? It's outrageous to ask you to work overtime on the first day you come to the emergency room."
Cao Xin came to the emergency room just to train herself.
If you want to get off work early, you might as well just stay out of your mind!
He immediately expressed his position: "It's okay for me to go back. I want to see what kind of disease this patient has and learn from it."
Zhou Sheng looked at Liu Zhengqing again.
Liu Zhengqing said nothing, but he had no intention of leaving at this time.
He was not the one who took over this patient. Now he is off work again. If it had been before, he would have left immediately.
But when he thought about leaving the emergency center soon, he said that as people leave, they leave their names, and as geese pass by, they leave their voices. Seeing that no one was leaving, he was too embarrassed to leave first.
Zhou Sheng could only say: "Well, since everyone is not leaving, let's wait for the patient to come back together. Depending on the time, it should be soon."
While Zhou Sheng was talking, the nurse took a stack of reports and pushed the boy back to the emergency room.