Chapter 177

"Junior Sister, take good care of this patient." Lu Chen stood up solemnly, "I'll go find Senior Brother Wang."

"Okay." Chi Jia still didn't quite understand what happened.

However, the blood pressure of the patient in front of him is indeed a little low.

According to his body type, it should definitely not be this blood pressure!
Lu Chen trotted all the way to the emergency room.

In front of the burn patient's bed, he found Wang Xiaodong.

"Brother, that patient just finished his abdominal CT."

Seeing Lu Chen's eager face, Wang Xiaodong knew that something might not be right.

"What's the problem?"

"Senior brother, let's take a look at the patient's abdominal CT image first." Lu Chen found a computer and brought up Cheng Lin's image in the imaging system. He pointed to the low-density liver lesion he found.

"Brother, look, what is this position...?"

Wang Xiaodong didn't notice any problems at first, but he didn't realize the difference until he saw the place Lu Chen was pointing at.

"This is... a low-density focus of the liver..."

In fact, low-density lesions of the liver can be seen in many situations. Benign diseases include hepatic cysts, heterogeneous fatty liver, liver abscess, hepatic hemangioma, hepatic adenoma, and cirrhotic nodules.

Malignant tumors include primary liver cancer and metastatic liver cancer.

These diseases all manifested as low-density shadows in plain CT scans of the upper abdomen.

However, at this time, Lu Chen was not considering these situations!

"Brother, the patient's blood pressure is low, and he may be prone to shock."

Shock, as we often say, refers to blood pressure less than 90/60mmHg.

But that's not an accurate definition.

Many patients' blood pressure is not lower than 90/60mmHg, but it may also be in shock.

This needs to be compared with the patient's usual blood pressure. Some people's usual systolic blood pressure is 180mmHg, but suddenly drops to 130mmHg, which may also cause shock.

"Junior brother, what do you mean, the patient is at risk of liver rupture?" Thinking of this, Wang Xiaodong sweated slightly on his forehead.

If it's a ruptured liver, then things will be a big deal.

"Yes! It's very possible!" Lu Chen nodded, "Although this low-density lesion is not large, and there may be cysts or nodules, we can't take this risk."

The liver is the largest digestive gland in the human body and an important organ for the metabolism and detoxification of substances in the body.

The normal liver is soft and easily ruptured by violence.

Under normal circumstances, closed hepatic rupture can be divided into three types from an anatomical point of view: central rupture, subcapsular rupture, and true rupture.

Clinically, death due to acute hemorrhage due to liver rupture is more common.However, death due to milder violence and delayed liver rupture is rare.

Violent blows or minor injuries from falls did not attract their attention, and they neglected to go to the hospital for examination, which easily delayed the timing of treatment. Chronic blood loss is very likely to lead to acute hemorrhage.

"I'll call the CT room first and ask them about the results of the film."

The CT has just been done, and the report will not come out so quickly.

Wang Xiaodong immediately took out his mobile phone and called the CT room.

In less than a minute, he hung up the phone.

"The teacher in the CT room said that this low-density lesion does not rule out the possibility of bleeding, and it is recommended to do enhanced CT." Wang Xiaodong looked at Lu Chen solemnly, "Junior Brother, let's go and see the patient first."

……

Emergency room.

"What? Do you want me to do abdominal enhanced CT?" Cheng Lin wanted to get up from the bed, but was pushed back by Lu Chen.

At this time, the patient should maintain absolute bed rest to avoid secondary injury.

"We found that there is something wrong with your abdominal CT, and the possibility of liver rupture cannot be ruled out." Wang Xiaodong said in a deep voice, "So, this enhanced CT must be done!"

"Liver... Liver rupture?" Cheng Lin's face turned pale.

His stomach was already aching, but at this moment, he felt even more painful.

"But... But I have been injured for two or three hours. If the liver ruptured, I should have reacted already?" Cheng Lin still couldn't believe that his liver ruptured.

When I heard the name, I felt terrible.

Chi Jia on the side also widened her eyes.

This patient is actually at risk of liver rupture?

The abdominal CT just now clearly showed no problems!

She herself is a graduate student in the Department of Gastroenterology, and she will still see the CT of the abdomen.

Why did a liver burst and bleed all of a sudden?

"If it is subcapsular rupture, that is, a small rupture wound, symptoms will not appear immediately. We call it delayed hepatic rupture and bleeding." Wang Xiaodong explained.

But the more he explained, the more scared Cheng Lin became.

He felt that his stomach pain was getting worse and worse.

"what happened to you?"

Lu Chen immediately noticed the pained look on Cheng Lin's face.

Moreover, the HP on his head suddenly dropped from 60 to 54!

"I, my stomach hurts..." Cheng Lin suddenly felt a cramping pain in his abdomen.

Both Wang Xiaodong and Lu Chen's expressions changed.

"Please call for an emergency consultation with the General Surgery Department!" Lu Chen shouted to Chi Jia, "Tell them that we have a patient who is highly suspected of liver rupture and bleeding, and has a tendency to go into shock. Hurry up!"

Hearing Lu Chen's order, Chi Jia also acted immediately, ran to the nurse's station, and started contacting the general surgery department.

At this time, Wang Xiaodong was performing an abdominal examination on Cheng Lin.

"There is tenderness in the abdomen, as well as rebound pain!" Wang Xiaodong said in a deep voice.

Lu Chen's face became more and more solemn.

There is tenderness and rebound tenderness in the abdomen, which means that peritoneal irritation has already occurred. 90.00% of patients have been diagnosed with hepatic rupture and bleeding, and the amount of bleeding continues to increase!

"Brother, let's transfer the patient to the emergency room first!"

Wang Xiaodong nodded, and the two worked together to push the bed in the observation room to the emergency ward.

The general surgery doctor arrived soon.

He was startled at the sight of the patient.

"Liver rupture and bleeding, combined with shock, and peritoneal irritation, urgent laparotomy is required!"

Wang Xiaodong immediately said: "Take the emergency green channel and push him directly into the operating room! We have already contacted his family."

"Okay." The general surgeon nodded, "I'll contact the operating room to prepare, and you can push it to the operating room now!"

Lu Chen, together with Chi Jia and another nurse, pushed the bed directly to the operating room in the surgery building.

"Xiaodong, it's a good thing you did an abdominal CT in advance." The general surgeon sighed, "If the diagnosis cannot be made in time, it will be a waste of time to do the CT when the patient becomes ill! The last time a liver The ruptured patient disappeared on the way to the operating room."

Wang Xiaodong nodded, feeling terrified.

This kind of hidden critically ill patients is the most fatal.

There were no special symptoms at the beginning, and once the condition changed, it would be too late for rescue!

This time, Junior Brother Lu Chen had to be careful, otherwise the consequences would be disastrous.

……

When Lu Chen pushed the hospital bed into the operating room, he was relieved.

"Congratulations, the completion of the system upgrade has increased by 10%!"

"Congratulations, the thank you from Cheng Lin is worth +1!"

"Congratulations, received a thank you from Wang Xiaodong +1!"

Senior brother Wang Xiaodong is really interesting, and he also gave him a little gratitude.

"Let's go, let's go back to the emergency department." Lu Chen said to Chi Jia, there were dozens of patients waiting for them in the emergency department.

"En." Chi Jia nodded, "Brother, how did you find out that the patient's liver ruptured?"

There are so many patients in the emergency room, why did this young man have an abdominal CT?

Lu Chen paused, and said, "Injured from riding a bicycle, or injured by the handlebars, these conditions are most likely to cause liver rupture. The patient also has symptoms of abdominal pain, although it is not obvious, but we cannot ignore it. The most important thing Surprisingly, there is a low-density shadow on the abdominal CT, so we have to highly suspect the risk of liver rupture!"

Of course, there is one more important thing Lu Chen didn't say.

That is the life value of the patient, which was only 63 at the beginning!

This is why Lu Chen focused on Cheng Lin.

"There are still low-density shadows on the abdominal CT?" Chi Jia was stunned, but she didn't find anything!

"I'll show you when I get back to the emergency room."

"Okay, thank you, brother." Chi Jia nodded.

This senior brother in front of him is very powerful, and he is willing to teach others.

At this time, another prompt popped up on Lu Chen's system panel.

"Congratulations, I received the thank you value from Chi Jia +1!"

He looked back at Chi Jia, this intern is also pretty good.

……

Back to the emergency ward.

Lu Chen was surprised to find that Wang Xiaodong was looking at the patients he selected in the emergency department, those patients whose life value was between 60-70.

Seeing Lu Chen coming back, Wang Xiaodong immediately waved to him.

Lu Chen came to Wang Xiaodong's side.

Wang Xiaodong handed the examination results of several patients in his hand to Lu Chen, and said, "Junior brother, I found that your vision is very vicious! After you selected these patients, after having them undergo examination, they more or less found some question."

Lu Chen smiled, took these reports, and said, "I'd rather do one more examination than let a patient with a problem go."

That's what I said, but Lu Chen really didn't do an extra check.

The middle-aged woman who had been wanting to have an examination was suppressed by Lu Chen.

"Junior brother, you did a good job." Wang Xiaodong said, "Go ahead and go to the emergency observation room. If the patient's condition changes, if you are sure, deal with it first, and then let the younger brothers and sisters come to me."

"Okay." Lu Chen nodded, and returned to the emergency observation room with Chi Jia.

……

It was already two o'clock in the afternoon.

Headquarters of Jinghua Medical University.

Skills Assessment Center.

Wang Zihao came out of the examination room and searched the entire examination center, but he couldn't find Lu Chen.

Looking at the ranking on the screen, Lu Chen's completed projects have not changed at all, and his ranking has been declining!
"What did Lu Chen do? He didn't come, did he?" Wang Zihao couldn't help thinking, "Could it be that he overslept in his afternoon nap?"

He called Lu Chen several times.

But no one responded.

"He didn't come, so what should we do with the assessment!" Wang Zihao was a little anxious, "I remember that he still has more than 20 items that have not been tested!"

……

(End of this chapter)

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