When doctors have a simulated operating room

The doctor was typing away on the computer and prescribing medicine, while asking Zhang Yi:

"Which hospital are you from, young man? You should not have taken the exam for attending physician at your age, right?"

He shook his work badge on his chest.

Zhang Yi took a look, oh, attending physician.

"I haven't taken the exam yet."

"That's right, according to my experience, your family's medicine should..."

"But I'm the assistant director."

Doctor Wang: "..."

What? !

Such a young assistant director? !

You're bragging!

After Dr. Wang raised his eyebrows and looked at Zhang Yi, he quickly prescribed the medicine and handed it to them.

After going to the pharmacy to get the medicine, Zhang Yi carefully checked it.

After confirming that there was no problem, he gave the medicine to Xu Changyuan.

"You know to take medicine on time, you are now a person with three highs. Also, you must not drink alcohol! I think I should take the bottle of Moutai at home or give it away."

Xu Changyuan immediately made a bitter face when he heard it:

"Ah? I... How about I take a bite before you take it away?"

Zhang Yi pretended to be angry and said:

"No! Not even a bite!"

Tang Xiaohe also pinched Xu Changyuan and blamed him:

"Now it's good, there is a doctor at home to take care of you, I wonder if you will still drink!"

Xu Changyuan had to sigh and said:

"Oh, now it's good , one more person who doesn't let me drink. "

"Uncle, you'd better check your blood lipids every year, okay? Otherwise, the blood will be too thick and block the blood vessels, which will be dangerous.

I'm a medical student, I understand all this, you must do what I say, okay?

And you have to arrange your weight loss, you are only 1.7 meters tall and weigh more than 170 kilograms.

You've grown sideways, you have to lose weight, okay?

Aunt, you must supervise him to exercise in the future, and fatty liver will be cured if he loses weight. "

Looking at Zhang Yi's serious nagging.

Xu Changyuan said that he was bothered, but he felt warm in his heart.

The few of them talked all the way from the pharmacy to the outpatient hall on the first floor.

Suddenly, Zhang Yi looked up.

I saw an old lady in her sixties being supported by her family and slowly sitting in front of the outpatient department of gastroenterology.

The family still had the examination form in their hands.

But Zhang Yi's expression became serious.

My goodness, this old lady has intestinal obstruction and still registered for the outpatient clinic? !

She doesn't dare to go to the emergency room? !

"Uncle and aunt, wait for me here!"

Before Xu Changyuan and Tang Xiaohe could react, they saw Zhang Yi had already walked to the old lady.

"Auntie, are you feeling uncomfortable in your stomach?" Zhang Yi squatted down and asked.

The two family members next to them saw the young man who suddenly came over and asked with some displeasure:

"Who are you?"

"I'm a doctor. I saw that the old lady was feeling a little uncomfortable, so I came to see her."

When they heard that Zhang Yi was a doctor, the family members nodded with relief.

It's too troublesome to queue up for registration and examination in this big hospital.

The old man felt uncomfortable in his stomach and wanted to come to see him, but when he came out after the examination.

The outpatient clinic was almost closed.

It's really frustrating!

"Doctor, can you help me look at this checklist?

My mother drank milk in the morning, and she felt uncomfortable in the stomach at noon after drinking it!

When I asked, she actually drank expired milk!

I really admire this old lady, she is so frugal every time!

She actually drank expired milk!

Now, she must have eaten something wrong with her stomach, right?

She started to have diarrhea and vomited before she even had lunch!

We immediately sent her to the hospital, but she ended up being an outpatient. After all the tests, it was almost four o'clock!"

The family members complained about the troubles of the hospital system.

Zhang Yi stared at the old lady in front of him who looked very bad.

Then he glanced at the checklist again.

Electrocardiogram:

P wave disappeared, QRS complex was widened and deformed.

Like Xu Changyuan, it was atrial fibrillation.

Abdominal CT showed:

The intestinal tract above the obstruction segment was significantly dilated, and the intestinal tract below the obstruction segment was collapsed.

There are shadows of food residues in the dilated area.

This is a typical CT manifestation of intestinal obstruction!

As a result, the diagnosis on the CT film reads:

Acute gastroenteritis?

This made Zhang Yi very confused!

The medical level of the First Hospital should be good, right?

How can the CT diagnosis of intestinal obstruction be wrong?

Then, Zhang Yi immediately looked up and said to the family:

"Take the old lady to the emergency room quickly, he is...

It's not ordinary gastroenteritis, intravenous infusion is useless! "

The family members were also anxious when they heard it, and asked hurriedly:

"What? ! It's not gastroenteritis? What's the situation? Oh my God, my mother won't be in any serious condition, right?"

Zhang Yi didn't answer this.

Intestinal obstruction, and the old lady is still strangulated intestinal obstruction.

It is a more serious type of intestinal obstruction.

Once complications occur, the old lady is likely to be in critical condition at her age.

(Critical condition means that the doctor notifies the family that the patient is in danger and may not be saved, so that the family members can be mentally prepared.)

Intestinal obstruction means that the intestinal contents are blocked.

There are many causes, such as intestinal inflammation, intestinal adhesions or tumors.

The clinical manifestations are also abdominal pain and vomiting, and the vomiting and diarrhea are very similar to acute gastroenteritis.

However, intestinal obstruction is also divided into types.

Contents caused by intestinal adhesions or tumor compression Passing through the obstruction is called mechanical intestinal obstruction.

Paralytic intestinal obstruction or spastic intestinal obstruction caused by the disappearance of intestinal motility or abdominal surgery is collectively called dynamic intestinal obstruction.

And the old lady in front of me.

None of the above.

It is blood-transmitted intestinal obstruction, also known as strangulated intestinal obstruction.

That is to say, she not only has intestinal obstruction, but also intestinal blood obstruction.

In Zhang Yi's sight, her intestinal blood obstruction has nothing to do with inflammation or compression.

It's a thrombus!

The thrombus just blocked the intestinal blood vessels!

This caused her intestinal obstruction and subsequent inflammation.

Just at this time, the old lady's face became paler and paler.

Her eyes rolled over and she fainted.

"Ah! Mom!"

The family members shouted in panic.

Zhang Yi hurriedly carried the old lady to the emergency department.

At the door of the emergency room of the emergency department.

Zhang Yi shouted:

"Hurry up and rescue! This old lady is in a coma due to intestinal obstruction! If complications occur, it will be dangerous! "

Intestinal obstruction can cause intestinal inflammation and intestinal necrosis.

Especially for strangulated intestinal obstruction, surgery must be performed immediately to remove the necrotic intestine.

If you delay, not only will the necrosis area increase.

A large amount of inflammation exudates into the abdominal cavity, which will cause diffuse peritonitis and even sepsis.

So intestinal obstruction must be operated on as soon as possible.

Here in the emergency department, the doctors and nurses in the emergency room did not know Zhang Yi.

But seeing that he was carrying an unconscious old lady on his back, they hurriedly pushed the stretcher over.

The emergency doctor also came over to ask about the old lady's basic situation.

Then he took the examination form in Zhang Yi's hand and took a look.

"Isn't this intestinal obstruction? Doesn't it say acute gastroenteritis?

Combined with the fact that the old lady drank expired milk in the morning, she had abdominal pain, vomiting and diarrhea, which is obviously acute gastroenteritis. "

Then, the doctor turned around and told the nurse:

"First do a cephalosporin skin test and prepare a large amount of fluid replacement. "

But unexpectedly, Zhang Yi stopped him!