Reasoning diagnosis: Big brother, your wife has been prescribed medicine!

Facing the anger of his family members, Wu Jiang had no choice but to bite the bullet and promise:
"Don't worry, once the interventional examination is done, you will know which blood vessel is bleeding."

Only then did the family pay the inspection fee again in doubt.

Soon, the interventional doctor sent the female patient to the interventional operating room upstairs.

Do a simple intervention check.

Contrast agent is directly applied to the whole body, and then observed with radiographs.

More than 20 minutes later, the interventional doctor called.

After hearing the result, Wu Jiang frowned, and asked in disbelief:

"What? Impossible? Intervention... I can't find the reason for the intervention?!"

Now Wujiang is really out of control.

In just over an hour, he exhausted what he had learned and all his experience in the emergency department over the past few years.

All the checks that should be done have been done, but the cause can't be found.

It's really evil!

Soon, the girl was sent back by the interventional doctor.

"No, I can't find it. I didn't find any bleeding blood vessels. But I observed it for a while, and the girl doesn't seem to be bleeding for the time being."

Wu Jiang was taken aback: "Huh? No bleeding?"

After all, he lifted the sheet and saw that the cotton pad he just put on did not have much blood.

Compared with the big pool of blood before, this one is really much less.

Bleeding decreased, indicating that the shock situation was temporarily stabilized.

But the worry in Wu Jiang's heart has not diminished in the slightest.

The core problem is still one, that is, the bleeding point is still not found.

There is no bleeding for the time being, which may be stopped by the patient's own factors.

But what if it bleeds again?

What if the amount of bleeding increases again?

Wouldn't the situation be more dangerous? ?

It's so weird.

The more you think about it, the more evil you get!
How can you not find the bleeding point?

Just at this time, the family members came to ask again.

"How is the doctor? How about the results of the interventional examination you mentioned? Where is my daughter bleeding?"

Wu Jiang was a little embarrassed, but he still told the truth:
"Your daughter's situation is so special that the interventional doctor didn't find any bleeding points after checking against the X-rays.

But the only good news is that your daughter's bleeding point has temporarily stopped.

It is not life-threatening for the time being, but we still need to continue to look for the bleeding point, so as not to suddenly start bleeding again next time. "

When the family members heard this, their complexions became more and more serious.

The girl's father immediately pointed at Wu Jiang's nose and cursed:
"What's the situation! We paid thousands of dollars, but in the end we couldn't find the reason?!"

"Sometimes it was said that the gastroscopy will produce results, and then it was said that the colonoscopy would produce results, and finally even the interventional examination was done, and it cost so much money for a set! Nothing was seen!
That means my daughter is still in a state of uncertainty?
Our money did not fall from the sky!

You have to give me an explanation today!Otherwise, don't even think about leaving! "

It was too late to wait for the result, and the girl's father couldn't bear the restlessness and fear in his heart.

After accumulating several times of resentment, it finally broke out towards Wu Jiang.

At this moment, when they heard the movement from the emergency room, these people came over one after another to watch the excitement.

Wu Jiang was also asked by his family members and didn't know what to say for a while.

In fact, many inspections must be done. If you don't do it, you won't get the result.

But this girl is too strange, even if she did it, she couldn't find out the result?

Faced with family members' doubts, although Wu Jiang felt aggrieved, he could only try to explain:

"Your daughter's condition is very complicated, and it is difficult to find out the result by conventional means."

"Well, I'll call another doctor on our side and let him take a look!"

The girl's father waved:

"Then hurry up!"

Afterwards, Wu Jiang immediately called Lin Yi.

As soon as he came to the emergency room, he saw Wu Jiang standing helplessly in front of an emergency bed.

There were two family members standing beside them with extremely ugly expressions.

In short, the atmosphere is not very good.

"Wu Jiang, what's the situation?" Lin Yi approached and asked.

When Wu Jiang looked up and saw Lin Yishi's eyes, he almost cried! !

Wu Jiang grabbed Lin Yi's arm and said:
"The girl had been taking diet pills for two months before the operation, and the specific medicines are unknown.

The girl said that she had some bloody stools these days, but not much, and the blood volume suddenly increased three hours ago.

He pulled blood directly in the toilet, and once reached the point of going into shock.

At present, 600 ml of whole blood has been given to her, and the bleeding has stopped and her blood pressure has stabilized.

But the strange thing is that the bleeding point was not found.

Colonoscopy and gastroscopy failed to find out, and then CT, color Doppler ultrasound, and even interventional procedures were performed, but no bleeding point was found.

It's so weird!I really couldn't think of a way, so I called the operating room to urge you. "

Lin Yi frowned while keeping his eyes on the girl:
"I have done all the interventions, but I still can't find the reason?"

"Correct!"

This is outrageous.

First of all, the large amount of bleeding must be due to rupture of blood vessels, otherwise so much blood would not flow.

Secondly, the blood flows out from the anus, so it is really necessary to do a colonoscopy and a gastroscopy to look at the digestive tract first.

However, when Lin Yi focused his attention on the patient's bile duct and pancreas, he instantly understood what was going on!
"Well, let me take a look at the patient's checklist first." Lin Yi said.

Wu Jiang hurriedly handed over all the inspection results just now to Lin Yi.

On the side, the family members watched such a young doctor come to help, and couldn't help wondering, can he do it?

And it looks younger than him!
Anyway, if they are asked to do any useless inspection later, they will never do it again!

If it's a big deal, I'll transfer my daughter to a big hospital in the province, and I won't waste any more time here.

After Lin Yi flipped through the checklist, he finally put the color Doppler ultrasound result on the top.

Wu Jiang glanced at the list and asked:
"What? Is there something wrong with this color Doppler ultrasound? This girl does have stones, but the stones are small, so I didn't think about it."

Lin Yi pointed to the color Doppler ultrasound sheet and said:
"No, her whole body is fine, but she has stones? And the location of the stones is so special??

No, there must be something wrong with this stone!

You can see for yourself that the location of the stone is on the common bile duct, and it is so close to the pancreatic duct of the pancreas.

Both the pancreatic duct and the bile duct are dilated. Is it possible that the bleeding point is caused by this stone? "

Wu Jiang couldn't believe it!

Unbelievably widened his eyes and said:

"No way! This...how is this possible?? The probability is so small! Impossible??"

Lin Yi shook his head and said:

"Nothing is impossible. You can do a gastroscopy again. This time, you must focus on observing the position where the duodenum connects to the pancreas."

"Then why is the girl not bleeding again now?"

Lin Yi thought for a while and said, "The stone may shift, and after scratching the blood vessel, it blocks the front end of the blood vessel. It may stop temporarily, but once it moves again, it will bleed again!"

Only then did Wu Jiang suddenly understand and nodded!
That's it!

On the side, Gao Han and Shen Lingyue, who were quietly watching the words, were also dumbfounded!
So... is that so? !
"Okay, I'll take the patient for a gastroscopy right now!"

As soon as Wu Jiang finished speaking, the voice of the patient's family members sounded behind them:

"We won't do it! We'll go to the provincial hospital right away! We'll be transferred to another hospital, so it's not up to you!"

It was the girl's father who spoke.

I tossed and tossed for several hours that night, and finally asked to have another gastroscopy.

The family quit!
Just as Wu Jiang was about to speak, Lin Yi gave him a hand and explained for him:

"Family, I understand your feelings very well.

You think that after your daughter came to the hospital, she spent thousands of dollars, not only did she not get treatment, but even the cause of the disease could not be found out, so you are very angry, right?
I know, and I can understand.

But every inspection done by Dr. Wu is a must-do item.

Your daughter is bleeding from the anus, and the amount of bleeding is so large, you have seen it yourself, right?

If you are not careful, it will be life-threatening, so the doctor must do all the tests that can find the cause of the bleeding.

And the follow-up examinations were done after the colonoscopy and gastroscopy, and they were done only after the reason could not be found, right?

Didn't I just ask you to do the whole set?
It's all step by step, and these checks are done step by step when the reason can't be found.

Now let me explain to you how special your daughter's situation is.

Look at this color Doppler ultrasound sheet, it says choledocholithiasis, right?

To be honest, stones are generally not related to bleeding.

But your daughter is special here. Now we suspect that it is because the calculus scratched the blood vessel during the movement, which caused the massive bleeding.

And just when doing colonoscopy and gastroscopy, it happened to move and block the bleeding port, so the inspection did not detect it.

Now we have to do another gastroscope, plus a color Doppler ultrasound.

See if the stone is displaced again.

This situation is indeed very rare, and we can only speculate, and find the correct cause step by step in the speculation.

But we can assure you that there is really no cheating of your money. "

After Lin Yi finished speaking, the two family members looked at each other.

There was obviously a little displeasure in his eyes, but when he heard Lin Yi say this, he also calmed down a little.

At this moment, the nurse suddenly ran over:
"Doctor Lin, that girl is bleeding again! The blood pressure is also dropping, down to 90!"

Hearing what the nurse said, several people rushed to see it.

Was lifted by a single, and sure enough it started to bleed again!

Looking at the big pool of blood, the family members also panicked!
"Woooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooo

"Trust us! Immediately have a gastroscopy and color Doppler ultrasound and make a diagnosis, then you can operate!
If the bleeding is really caused by stones, the damaged blood vessels have to be cut off and then ligated to stop the bleeding! "

Lin Yi looked at the family members and said sincerely.

The girl's mother nodded with tears in her eyes:
"Okay, do it...we'll do it all...please, get my daughter cured...she's still so young!"

Lin Yi also nodded heavily:
"Don't worry, we will do our best."

Later, while the family paid the fee, the girl was also sent for another gastroscopy.

The gastroscopy doctor saw Wu Jiang and Lin Yi's surprised faces:
"Didn't you find the reason just now? Why did you do it again?"

Lin Yi explained: "Please focus the camera on the duodenum this time. I want to see the outlet of the pancreas."

The doctor nodded: "No problem, do you suspect that the girl's bleeding point is in the pancreas?"

Lin Yi did not deny it: "This possibility is not ruled out."

The human gallbladder is connected to the liver, and the common bile duct below the gallbladder is connected to the pancreas.

After entering the root of the pancreas, the common bile duct merges with the pancreatic duct (Y shape) and enters the duodenum.

The opening, or root, of the pancreas begins with the duodenum.

It is equivalent to saying that the secretions secreted by the bile duct and pancreas will be discharged from the duodenum.

There is even a disease called bile reflux gastritis, because bile does not go down after it flows into the duodenum, but goes up into the stomach.

This stomach disease is caused by stimulating the gastric mucosa.

So why sometimes when one organ has an accident, other organs will also have an accident.

It is because the organs of the human body are almost all connected.

Only those who work together can be healthy. If there is a strike, maybe other organs can help to compensate, but after a long time, all the strikes will follow.

If you don't do it, I won't do it, everything is bad, and people will belch along.

The pancreas is actually a digestive organ in the upper gastrointestinal tract.

But its effect is not as great as that of the stomach and intestines, so it is sometimes easy to ignore.

At this moment, the gastroscopy doctor quickly inserted the gastric tube into the girl's mouth.

In the display screen, the flesh-pink tissue kept protruding downwards.

From the esophagus to the fundus of the stomach and the pylorus to the duodenum.

After arriving at this position, several doctors began to stare at the screen intently, for fear of missing a little blood.

"Down a little bit and look at the outlet of the pancreas."

"it is good."

The camera turned again, and when it aimed at the exit of the pancreas, everyone showed expressions of disbelief!
I actually saw bloodshot eyes!

"This...is it really bleeding here?!"

At this moment, Wu Jiang felt that Lin Yi was simply a fairy!
He just glanced at the checklist and knew it was the problem with this little calculus? ?
But I checked for a long time and couldn't find it!

The gastroscopy doctor was also a little confused, and said:
"Strange, why didn't we see any blood when we did it just now?"

Lin Yi explained: "The cause of this girl's bleeding is very rare and complicated. It is related to stones. Maybe you didn't have bleeding when you did it just now, so you didn't observe it."

"I see!"

Here are the results of the gastroscopy.

The reason why the anus pulls blood is that the bleeding point comes from the root of the pancreas, and then flows into the duodenum.

"Finally confirmed! Now we have to do another color Doppler ultrasound to check the condition of the bile duct and pancreatic duct and whether the stone has been displaced." Wu Jiang said excitedly.

He couldn't see what was going on inside the girl, but Lin Yi could.

The stone has been displaced!
And it ran into the pancreatic duct!

There is no delay, and I have to finish the color Doppler ultrasound immediately and send the patient to the operating room.

"Notify the blood bank first, and then bring over [-] milliliters of whole blood."

Lin Yi ordered this because he was worried that this small stone would cut through the blood vessels of the pancreas again.

The amount of bleeding will become greater.

According to the current state of the girl, she may die of shock within a few minutes.

Soon, the color Doppler ultrasound results came out.

Wu Jiang was shocked!After comparing the two checklists, he said:

"It's really shifted! And the bile duct and pancreatic duct are enlarged?! This shows that there is bleeding inside!"

"It's not too late, send it to the operating room!" Lin Yi urged.

It would be easier to explain it to the family members after the reason is found.

Although the girl's father still has a lot of dissatisfaction, he also knows that the operation as soon as possible is the most important right now.

So I quickly signed the consent form for surgery.