Chapter 139 Diagnosis: Splenic Rupture (Part 3)
The woman's voice attracted some doctors.
Wei Ping is one of them.
And Yang Ke followed behind.
At this time, Guo Yongping also walked out of his office.
He walked towards the patient.
"What's wrong?"
"Doctor, my stomach hurts! It hurts so much! Give me some painkillers quickly! I can't stand it." said the woman.
Guo Yongping refused.
"Don't take painkillers until the condition is diagnosed! They will mask the condition and make diagnosis more difficult."
If you take painkillers at this time, it will only cover up the affected area.
If it is an emergency, it will cause very serious consequences.
Wei Ping saw that the female patient had her hand on her ribs.
Some distance from the belly.
There are many organs in the ribs, and he initially judged that there might be organ disease.
It could also be intercostal neuralgia.
Even more serious is herpes zoster, which initially presents with no obvious blisters and only painful symptoms.
Another possibility is pain caused by a life-threatening organ rupture.
All these need to be taken into consideration.
Then many interns came over.
Guo Yongping looked at these people.
Asked the patient some more questions.
For example, what you ate recently, when did the pain start, etc.
Based on these things, he made an initial judgment.
"Acute abdominal pain may be caused by intestinal spasm or inflammation. First, perform a routine abdominal ultrasound and then draw blood for testing to see if there is an increase in white blood cells. Then proceed to the next step."
At this time Wei Ping stopped him.
"Wait a minute, I don't think so! If we do that, we'll waste a lot of time."
Guo Yongping was shocked.
Wei Ping actually dared to challenge his authority in front of everyone.
"Xiao Wei, what do you think? What do you think the disease is?"
Guo Yongping said sarcastically.
Wei Ping ignored him.
Instead, go to the patient.
Gently press two fingers above the patient's left lower rib.
The female patient immediately screamed.
"It hurts! Don't press it!"
"Have you fallen recently? Did you hit anything hard on the left side?" Wei Ping asked directly.
Guo Yongping was shocked.
Because he understood why Wei Ping asked this question.
The female patient was unhappy.
"Help me relieve the pain quickly and stop asking questions like this! What's wrong with you doctors? Didn't you make a diagnosis? And you even have the right to overturn it!"
"If you don't tell me, your life may be in danger! Think about it carefully!" Wei Ping said loudly.
He was also anxious at this time.
Everyone was in a hurry.
Guo Yongping looked at Wei Ping, then at the patient.
At this time, the surroundings became quiet.
"Let me think about it!"
The woman suddenly became quiet.
She no longer questioned Wei Ping. After all, if what Wei Ping said was true, she might die.
She thought for a moment and said:
"A week ago, I accidentally fell down while riding an electric bike home, and hit the handlebars here! But it's been a week, and my internal injuries should be healed soon, right?" the woman said again.
Wei Ping immediately felt something was wrong, and he did not hesitate.
Just turn on the perspective.
APP prompts: "Perspective experience +1, 258/1000"
He quickly checked the woman's lower left ribs.
The cause was quickly discovered.
It's a ruptured spleen!
At this time, the spleen was still bleeding, and the situation had become urgent.
The spleen is an important blood storage organ. It is as soft and brittle as tofu and is particularly prone to rupture when hit. Once it is accidentally injured, seek medical attention in time.
Especially in car accidents or falls, when the abdomen is violently impacted, the liver on the right and the spleen on the left are most likely to rupture.
Traumatic violence can easily cause the spleen to rupture and cause internal bleeding. The spleen is one of the most vulnerable organs in the abdominal cavity, and its incidence accounts for almost 20% to 40% of various abdominal injuries.
The most important thing is that if the spleen ruptures and bleeds, unless the damage is particularly severe, the patient may have no other obvious symptoms except mild pain in the left upper abdomen, and it can easily be overlooked in the early stages.
Once the spleen capsule is ruptured by a large amount of blood, the ruptured blood vessels of the spleen lose compression, the spleen bleeding rate will accelerate, the disease will progress very fiercely, and shock or even death is likely to occur.
With this perspective as the basis.
Wei Ping made a judgment immediately.
"I suspect a ruptured spleen! Please do a chest CT scan first! Quick!"
Guo Yongping said, "Wouldn't it be faster to do a B-ultrasound?"
"I think CT is better! It can see the rupture more clearly! If ultrasound can't see it, it's a waste of time. The patient might go into shock or even die! Wouldn't it be better to scan everything at once?"
Wei Ping’s words make a lot of sense.
It’s better to do it right the first time.
"What if it's not? That's a waste of the patient's money!"
Guo Yongping said.
"If not, the extra money will be deducted from my salary! Hurry up, someone send the patient to the emergency CT room. Then notify the surgeon to come over. I think this needs immediate surgery!"
Splenic rupture is mainly treated with surgery.
Those who meet the indications can also undergo laparoscopic minimally invasive surgery, which has less trauma and faster recovery.
The corresponding treatment plan according to the "grade of spleen injury" is:
Level 1: non-surgical treatment, adhesion and coagulation to stop bleeding;
Level 2: Suture repair
Level 3: Splenic artery ligation
Level 4: Total splenectomy
Wei Ping saw the patient's spleen, which was a second-level operation.
After he said this, no one dared to move.
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