Signing in at the hospital, the first operation shocked the whole country!

normal!

"Doctor Han, this..."

The obstetrician was also helpless.

wow~

Just when the three of them were at a loss, the woman suddenly opened her eyes and sat up abruptly.

The situation startled them, but they calmed down immediately.

"How are you? Is it still hurting?"

Han Xiaoxiao walked to the woman and asked.

......

The woman's expression was a little stiff, and she just looked at her when she heard what she said, but didn't speak.

Seeing this, Han Xiaoxiao felt something was wrong, so he raised his voice and asked twice.

Still nothing happens!

The woman's pupils dilated and contracted, and her mind seemed to be in a trance, as if she didn't hear it.

"Could it be pregnancy syndrome?"

Seeing this, the female doctor in the obstetrics and gynecology department couldn't help but wonder.

Pregnancy syndrome may include depression and minor nervous disorders due to emotional anxiety, resulting in trance.

This is medically possible.

"Hiss~ It hurts!"

Suddenly, the woman seemed to come to her senses, clutching her stomach and crying out for pain again.

The three of Han Xiaoxiao were completely dumbfounded, and their expressions became more dignified.

Can't find out the cause, there is no way to solve it!

"There is no abnormality in the B-ultrasound, the liver and gallbladder are also frequent, and there is no pelvic effusion. How about a gastroscopy?"

The gastroenterologist asked with a frown.

"Could it be a cornual pregnancy?"

At this moment, the obstetrician and gynecologist pondered.

Cornual pregnancy, a special kind of ectopic pregnancy, is a pregnancy in which the embryo is implanted in the uterine horn close to the junction of the uterus and fallopian tube opening.

There are generally three types of cornual pregnancy.

One is that the gestational sac stops developing and miscarriage occurs;

The second is that the gestational sac expands outward at the uterine horn and eventually causes the uterine horn to rupture;

The third is that the expansion of the blank fetus to the uterine cavity is delayed until the late stage to achieve a successful delivery, because the muscle tissue of the uterine horn is weak, and it is also the anastomosis of uterine blood vessels, ovarian arteriovenous and fallopian tube blood vessels, with rich blood supply.

The gestational sac is planted here, and as the pregnancy progresses, the base layer may rupture and the bleeding will increase. If the diagnosis is delayed, it may be life-threatening.

If it is really a cornual pregnancy, combined with the woman's current situation, it is likely to be the third type.

Moreover, once the pregnancy reaches the second trimester, the B-ultrasound is difficult to find out.

Hearing her words, Han Xiaoxiao and the gastroenterologist changed their expressions.

If it is really a cornual pregnancy, it is very likely that the uterine wall is ruptured, and even life-threatening.

It is necessary to flow people in advance!

"Why don't you have a gastroscopy to rule it out?"

The gastroenterologist then suggested.

"I agree."

The obstetrician and gynecologist nodded.

First rule it out, if it is really possible, you need to investigate it.

After all, the patient is now in the second trimester of pregnancy, and CT cannot be easily performed if the diagnosis cannot be made.

"How about I ask the director to take a look?"

Han Xiaoxiao was a little hesitant, and said in embarrassment.

Hearing this, the other two doctors nodded.

It is best to have a leader at this time, and this is an emergency department, of course the leader on duty in the emergency department.

finished,

Han Xiaoxiao walked quickly to the office.

"Director Qin, can you take a look? There is a patient who is very troublesome, and the cause cannot be found."

Qin Feng raised his head when he heard the words, then got up and asked.

"what's the situation?"

"The patient is a female, 35 years old, 16 weeks pregnant, and suddenly developed abdominal pain. She was checked in two or three hospitals below, and no problem was found, so she was transferred to us."

Han Xiaoxiao quickly explained the situation,

"We conducted a detailed inspection, but all the results were fine, B-ultrasound, blood routine..."

The two talked while walking, and after listening to all the process, Qin Feng also showed a surprised expression.

Can't find the cause?

The obstetrics and gynecology suspected cornual pregnancy.

If it is true, then there is indeed some trouble!

"Ouch~"

In the rescue room, Qin Feng watched the woman on the bed clutching her swollen stomach, sweating from the pain.

"Don't move, I'll check it out for you."

He put on his stethoscope and reassured the woman as he spoke.

"Does it hurt? Why does it hurt?"

......

After a simple physical examination, Qin Feng picked up the examination report and went through it.

There was no abnormality in the examination, excruciating pain in the abdomen, and a trance......

This situation is difficult to judge!

Abdominal pain is the basic symptom of a large number of diseases, such as various acute abdomens, including kidney stones, gallbladder and common bile duct stones, acute pancreatitis, gastric or duodenal ulcers, acute appendicitis, intestinal obstruction, etc.

If you don't know the cause, you can't determine the treatment plan at all.

And his examination also confirmed that it should have nothing to do with the patient's digestive system.

Then the rest is the cornual pregnancy proposed by the obstetrics and gynecology department.

But before this check, you still have to rule out everything that can be ruled out!

"In this way, check her PAS, blood biochemistry, do a urine test PBG, ALA, let the laboratory department expedite, and let the neurology doctor come over."

Qin Feng thought for a long time, and did what he needed to do, so he started from other aspects to see if he could find clues.

At this moment, he is also constantly sorting out and excluding in his mind. Based on the patient's age, life status, recent situation, examination status and other factors, he sorts out the most likely symptoms of abdominal pain.

Among them, three diseases were quickly locked on.

Collateral reaction caused by pathological neuropathic pain, rare acute porphyria, acute biliary tract disease.

Be the first to do an inspection!

Biliary tract problems require CT, which cannot be done now.

Neurological problems should be judged by neurologists, and porphyria is a rare disease that most people would never think of.

But precisely acute asymptomatic abdominal pain is a sign of acute porphyria!

The most important thing is that when Qin Feng checked the woman, he found an unexplained nervous system dysfunction, especially local muscle weakness and stiffness in the arms and legs.

He guessed that the woman's current situation, if not for neurological problems.

That is likely to appear in the blood and biliary tract!

Chapter 320 Diagnosed with a rare disease, easy to handle

"Director, what should we do now?"

Han Xiaoxiao looked at the woman in pain and couldn't help asking.

"Push a Valium first, and wait for the test results to come out."

Qin Feng thought for a while and said.

Han Xiaoxiao nodded, and then began to operate.

"Director Qin, then we..."

The doctors from the Department of Gastroenterology and Obstetrics and Gynecology looked at each other.

"Hehehe~ Let's wait for a while, let's see the result together."

Qin Feng laughed.

About 10 minutes later, a doctor from the clinical laboratory hurried over with a report in his hand, looking very happy.

"Director Qin, this is the report you want, and there is indeed a problem."

Hearing this, Qin Feng immediately took over to check the inspection results.

In the next second, his eyes softened a lot, and a smile rose from the corner of his mouth.

really!

"Okay, I found out."

As he spoke, he handed the inspection report to Han Xiaoxiao and the others.

Han Xiaoxiao took it over, and was stunned when he saw the indicator above, and showed a clear expression in the next second.

Acute intermittent porphyria!

No wonder the hospitals below and they couldn't find out no matter how hard they checked, it turned out to be this disease!

Porphyria, also known as porphyria, is a group of porphyrin metabolic disorders caused by the lack of certain enzymes or reduced enzyme activity in the heme synthesis pathway.

It can be congenital or acquired.The main clinical symptoms include photosensitivity, digestive system symptoms and psychoneural symptoms.

Acute intermittent porphyria is the most common form of porphyria.

The clinical features are abdominal cramps, intractable constipation, mental symptoms and excretion of a large amount of ALA and porbilinogen in urine.

The symptoms of acute intermittent porphyria are mainly acute abdominal pain, intractable constipation, paresthesia or loss of lower limbs, paraplegia or quadriplegia, facial nerve paralysis, dysphagia, neurasthenia, personality changes, abnormal urine color, etc.

The most common is acute abdominal pain, and the location of the abdominal pain is not fixed. It may be around the navel, upper right quadrant, lower right quadrant or even the entire abdomen. It is often misdiagnosed as intestinal spasm and colic.

This disease is a rare disease among difficult and miscellaneous diseases, and it is rarely seen in general.

The most important thing is that the patient is a pregnant woman, which makes the examination and diagnosis more difficult.

So after three hospital transfers, there was no result!

"Is the patient's family here?"

Once the cause is confirmed, the rest will be easy to handle.

After three doctors from other departments went back, he met the woman's husband.

"You are the patient's lover, aren't you?"

Qin Feng looked at the man and asked.

"Yes, doctor, what's the matter with my wife?"