Chapter 1557: What is the aortic ulcer?

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"Doctor, my lover's illness is not serious." In the emergency room, a middle-aged woman followed the physician.
Zheng Ren is stunned and hears someone talking in his ear.
"Heavy!" The physician said with certainty that "the gastrointestinal tract is bleeding, there is a faucet that whipped up blood, do you say it is heavy?"
The emergency doctor said, looking up at Zheng Ren, greeted "Zheng Zong, the director's illness is okay?"
"Nothing." Zheng Ren smiled. "What patient?"
"Nausea, vomiting, low blood pressure, consider upper gastrointestinal bleeding, ready to enter the hospital."
This situation is more common, the portal surgery for patients with portal hypertension is a kind of, gastric fundus, intestinal mucosa ulcers, rupture and bleeding is also a kind.
If it is not the portal hypertension and cirrhosis of the gastric varices, the general bleeding of the arteries will not be very large, admitted to the hospital for gastrointestinal decompression, static hemostasis drugs, there is a 23-day is almost.
"How much blood pressure?" Zheng Ren casually asked.

75/50hg.
The emergency physician took the patient’s family to open the hospitalization order and left a data for Zheng Ren.
Fortunately, although it is shock blood pressure, it is not particularly low.
Zheng Ren probe gave a look, a middle-aged man lying on the bed in the emergency room, pale, and the value displayed by ECG monitoring...
How is blood oxygen saturation so low? There are also some problems with the waveform of the ECG oscilloscope.
Zheng Ren felt that it was wrong. He took a look at the door.
The system panel is scary, the diagnosis is like dripping bleeding - a large amount of pericardial effusion, aortic adventitia ulcer.
Hey... What is this disease?
Zheng Ren knows that the doctor in the emergency department diagnosed wrong. As for why he made this mistake, he did not think about it for the time being.
He immediately opened a drawer on the console with a mercury sphygmomanometer and stethoscope.
Picking up the stethoscope, Zheng Ren began to auscultate the patient.
The lungs can smell a lot of wet rales, and the heart sounds are far and wide. It is indeed the heart sound of the heart pack.
Because it is a man, Zheng Ren did not go to check if there was any patient who had encountered the "Yi Rong" last time.
Pericardial tamponade is also divided into acute and chronic. If it is traumatic, the heart breaks a big hole, the blood can't go out, and it is piled up in the pericardium, which belongs to acute pericardial tamponade.
If the heart is insufficiency and renal insufficiency can lead to fluid circulation disorder, chronic pericardial tamponade occurs.
It can be understood that there is a pericardial effusion, and even a pericardial tamponade. But what is a devil's diagnosis of aortic ulcer? how did it get here?
The aorta also has ulcers. This condition refers to the formation of ulcers in the aortic atherosclerotic plaque, which is caused by the penetration of the inner elastic layer.
However, large pig hooves give aortic adventitial ulcers.
Have inflammation? Still something else?
I was thinking that the emergency doctor had finished the hospitalization of the hospital for digestive medicine and went out to greet the patient to go to the hospital.
When she saw Zheng Ren checking the body in front of the bed, she asked "Zheng Zong, what happened."
"First, don't worry about hospitalization, open a lung ct." Zheng Rendao "What is the medical history?"
The emergency doctor sneaked a bit, and it was clear that the upper gastrointestinal bleeding, Zheng always did not let the hospital, but also open the lung ct check?
"Men, 42 years old. I came to our hospital for repeated nausea, vomiting and breathing difficulties for 3 hours." Although there are doubts, emergency physicians are still habitually reporting medical history.
The superiority of the doctors at the higher level is not a joke. They have long been used to nature.
"The patient suddenly had difficulty breathing 3 hours ago, slightly feeling chest tightness, with nausea and vomiting many times, each time a small amount of stomach contents and a small amount of brown color, no abdominal pain, no relationship with the eating position. There is incontinence, stool is yellow thin It will be."
"Nausea and vomiting? Brown?" Zheng Ren asked.
"Well, occult blood is positive, considering upper gastrointestinal bleeding. Because there is no hematemesis, bleeding should not be very serious," the emergency physician said.
Zheng Ren meditates.
Things are not right.
According to the medical history, the diagnosis of the emergency physician is correct.
Nausea, vomiting, spit out of the test, occult blood positive, inferior upper gastrointestinal bleeding. It's all logical, without any problems.
But why do you have difficulty breathing?
See Zheng Ren looking at the patient's daze, the emergency doctor said in a whisper, "Zheng Zong, take the time to send the Department of Gastroenterology, if the bleeding can not stop, but also to rescue what."
In the emergency department, after the diagnosis, where to send it.
They are all rescued in the emergency department. This is also too busy.
There are dozens of dozens of emergency patients outside, and when they have a bad temper and are in a hurry, they are really open-minded.
Even if it is beaten, it is not uncommon.
It is not uncommon to be rescued with a slap in the face.
Zheng Ren shook his head and said, "Go open a lung ct, I will take the patient to check."
The emergency doctor did not know why Zheng Ren insisted, and she did not hesitate. The superior doctor said that he also gave his opinion. If he did not listen, he would follow the doctor's advice.
When the sky collapses, there is a higher-level doctor who is holding a ~EbookFREE.me~ afraid of it.
"What patient, boss." Su Yun finished the female student and returned to Zheng Ren.
"It's weird, you listen." Zheng Ren gave the stethoscope to Su Yun.
"Well? Strange?"
"According to the medical history, the patient is diagnosed with upper gastrointestinal bleeding, there is no doubt. But auscultation of both lungs and pericardium has problems, I am going to take the patient to take a ct look."
Su Yun will be suspicious of holding a stethoscope and starting auscultation.
In less than a minute, he looked up with a dignified look. "There is a problem, take time to check."
After that, Su Yun asked "upper gastrointestinal bleeding?"
"Nausea, vomiting, vomit occult blood test positive."
"Zheng Zong, ct list is over, are you taking it?" the emergency physician asked.
"Ok."
The patient's family was a bit embarrassed. I just said that I was sent to the Department of Gastroenterology. The doctor also described the condition very seriously. It may be dead later. How do you check now?
"Doctor, what happened?" The family members of the patient asked with some anxiety.

Is it traumatized recently?
Zheng Ren did not explain, and asked the patient to carry the patient into the flat car with the help of the company.
"Recently? No." The patient's family said, "I suffered an injury a few years ago, a fracture of the clavicle, and surgery. It has been normal for nothing recently."
Zheng Ren glanced at the patient's left sternum area with old surgical scars, which was a long time ago.
Strange, no trauma, where is the aortic adventitia ulcer?
According to the diagnosis of the big pig's hooves, Zheng Ren began to ponder.
But no matter what you think, it’s a dead end, and there’s no idea at all.
Zheng Ren and Su Yun pushed the flat car, trotting all the way, and accompanying the patient to the ct room.
It was not until the patient got on the bed and started to do ct.
.