Start From Emergency Doctor

Chapter 499

Now Zhou Yuan hopes to meet patients with abdominal pain the most, and it must be complicated.

The system update is coming soon, even Zhou Yuan is very much looking forward to it.

“Go to your place and have a look. You can tell me the specific situation on the way.” Zhou Yuan said.

He Jing nodded and walked ahead to take the lead.

The patient was a 23-year-old woman who was four months pregnant with abdominal pain.

Because it was the first pregnancy, the patient mistakenly thought that abdominal pain was a normal symptom of pregnancy, so she didn’t care too much. It wasn’t until the abdominal pain lasted for nearly a week, and from the initial dull pain to the point where it affected sleep, she reacted to the hospital.

The previous medical history was relatively simple, and he was allergic to penicillin. He had an appendectomy three years ago. During the previous check-up, ultrasound showed that he had twin uterus.

The so-called twin uterus is a kind of malformation of the reproductive tract. The cause is that before birth, the Mullerian ducts on both sides of the embryo develop normally but are not completely fused, which leads to the growth of two uteruses.

The two uterus are often attached with their own independent fallopian tubes, each with complete functions, often accompanied by dual sound channels.

In theory, this is not an overly serious disease and will not be life-threatening.

Therefore, as long as it does not cause clinical symptoms, there is no need for treatment.

But abdominal pain obviously has nothing to do with the double uterus.

The patient’s current medical history is more complicated.

Menstruation is often irregular. According to the patient’s oral statement, the time of menstruation has not been fixed since puberty. The specific time of the last menstruation is also uncertain, the amount of menstruation is too high, and there is no dysmenorrhea.

The other is abdominal pain. Intermittent abdominal pain occurred a week ago, which was not serious at the time, but the condition worsened in the past few days, abdominal pain was obvious, and it developed to the point where sleep was affected, so I transferred to Yanjing Traditional Chinese Medicine Department of Obstetrics and Gynecology, Department of Obstetrics and Gynecology. Over there, he switched to the obstetrics department where He Jing was.

After the physical examination, the patient showed a drop in blood pressure, anemic appearance, clear consciousness, indifferent expression, unresponsiveness, etc…

In addition, the patient has a distended abdomen.

The preliminary judgment is the swelling caused after pregnancy, but it cannot be ruled out whether there is abnormal swelling caused by the disease.

The whole abdomen tenderness is obvious, and I cannot bear it. But there is no obvious rebound pain and muscle tension.

Because the patient was pregnant, many examinations could not be carried out easily. The obstetric department only gave an internal examination. The final result was that the sound channel was unobstructed, there was no bleeding, the cervical canal was hard in the center, and the uterine orifice was not opened. There was nothing wrong.

After the introduction, the two also rushed to the obstetrics department.

Before He Jing asked about the immediate condition of the pregnant woman with abdominal pain, a nurse hurriedly walked out of the obstetrics department.

She looked a little flustered, and became even more anxious after seeing He Jing, “Doctor He, the patient is in shock!”

But immediately, she immediately noticed Zhou Yuan next to her, her face suddenly relieved a lot, and calmly added: “The woman with abdominal pain sent yesterday has just had shock!”

Zhou Yuan and He Jing glanced at each other, and both realized the seriousness of the problem, and stopped asking, He Jing immediately led the way, and the two entered the ward.

There was a slightly thin woman lying on the hospital bed, now pale and lying on the bed.(Read more @ wuxiax.com)

There are a few people next to the bed, two middle-aged couples, one man, should be the parents of the man and the woman.

“Doctor, my daughter suddenly went into a coma!” The woman’s mother stood up anxiously.

Seeing the doctor’s arrival, she seemed to have grasped the straw.

He Jing and Zhou Yuan stepped forward and immediately performed a physical examination.

Fortunately, the patient’s various physical values ​​were normal, and he woke up after a simple treatment.

Zhou Yuan saw that the patient was temporarily okay, so he picked up the detailed medical record and read it.

Unexplained abdominal pain…

Is the uterus ruptured?

Or is it caused by a ruptured spleen?

A ruptured spleen may have symptoms of abdominal pain and shock, and it is also possible.

However, there are other possibilities.

“Did you have an ultrasound examination?” Zhou Yuan asked.

He Jing shook her head: “Not yet. The last ultrasound was during a maternity check. Because of concerns about the impact on the fetus, the patient and family members did not agree to ultrasound.”

Zhou Yuan frowned.

The output power of ultrasonography is very small and has no obvious impact on the fetus. Nowadays, mothers have abdominal pain of unknown cause, and various examinations must be perfected, otherwise an accident will be two lives.

As if seeing Zhou Yuan’s meaning, He Jing was a little flustered and explained in a low voice: “I told them, but they said that they really can’t find it and consider ultrasound.”

There was a moment of silence in the ward. At this time, the mother’s husband stood up and said, “If you really can’t find it out, please trouble you to check on my wife… If there really is an accident, I must let my wife survive!”

Zhou Yuan did not speak…

Things like keeping big and keeping small will only appear in TV dramas.

In real life, there is no such thing as keeping the big or small in the hospital, but in any hospital that is slightly more formal, you can only choose between the fetus and the mother. No matter what the family members say, the hospital can only let the mother survive. .

In our country’s law, a fetus is not considered to be a complete life before the birth, and only a woman who is part of a child can be regarded as a person in the true sense.

Therefore, neither the medical environment nor the law allows abandoning the mother in order to protect the child.

With the opinions of family members, the patient was sent for ultrasound soon.

The ultrasound results surprised Zhou Yuan and others.

The first is the twin uterus, which was diagnosed during the previous birth check.

In addition, the muscular layer of the anterior wall of the uterus is faintly visible with partial continuous interruption and complete placenta previa!

There is a more serious situation. The imaging department avoided the patient’s family members before they were willing to tell Zhou Yuan and others about the situation.

“The stillbirth in the palace!”

He Jing’s face changed.

No wonder you have to avoid patients’ families!

The imaging doctor said: “The patient had an intrauterine stillbirth with fluid in the abdomen and pelvic cavity, accompanied by blood clots!”

At this moment, Zhou Yuan’s mood was extremely calm.

Intrauterine stillbirth, isn’t it just to remove the stillbirth?

Clearing the stillbirth in the womb-induction of labor…

Isn’t this something you obtained by opening a treasure chest a few months ago?

At that time, he felt that sooner or later it would come in handy, not just today.

Zhou Yuan thought for a moment, then suddenly asked: “Can intrauterine stillbirth cause abdominal pain?”

He Jing, who was still in shock, reacted and thought for a while, and came to: “Even if it is an intrauterine stillbirth, the abdominal pain will not last for a week! Intrauterine stillbirth may be one of the causes of abdominal pain, but it is definitely not the main reason!”

In other words, the cause of abdominal pain was still not found.

It’s just that I am sure to perform an operation to clear the stillbirth for the patient.

“Zhou Yuan, what should I do?” He Jing suddenly became embarrassed.

Where do the maternal, intrauterine stillbirth, twin uterus, and abdominal pain in April come from? .