Chapter 885 Meat Volcano
He had checked before, and although the patient's spine was deformed to a certain extent, it was not so severe that he had a hunchback.
Then the possible explanation was... In addition to the ulcer in the thigh, the patient also had abdominal pain.
"Not sure..." The accompanying family member was a little confused.
Another person said: "My mother has always been like this, and she never said she was in pain."
Careless family members...
Xu Qiu silently commented and was about to go forward to check.
However, although the patient was not fully awake, his body's resistance was very strong. Xu Qiu was afraid of breaking the old man's bones, so he gave up.
He could only settle for the second best, squatting aside and slowly lifting the hem of the patient's clothes.
As soon as he opened it, a strong odor hit him in the face.
Xu Qiu's body shook, and he was caught off guard, and his eyes felt like they were stung.
"This..."
He quickly signaled the nurse to turn on the light.
Click.
The light of the flashlight shone under the clothes, and Xu Qiu suddenly saw a wound that was sunken inward.
It was like a flesh volcano growing in the abdomen.
The surrounding area is a bulging, protruding mass of flesh, composed of abdominal fat and muscles, stacked up in layers.
The middle part is sunken inward, and the wrinkled skin has a hole the size of a finger, and the dark hole replaces the original belly button.
"This is..."
Xu Qiu was slightly surprised.
Other emergency doctors may find it unfamiliar, but he saw it at a glance.
Common cesarean section injuries in obstetrics and gynecology!
To be more precise, the incision during the operation is too large, the postoperative suture is not done carefully enough, or even a mess, and the postoperative care is not in place, which may cause this result.
Judging from the wound, it is just a rare serious sequelae after childbirth...
However, this patient is already in his seventies.
The family members accompanying the bed all look in their forties, and the menopausal age of women is around fifty, which means that even if the patient gave birth to a child before menopause, it has been at least twenty years.
This flesh volcano-like wound has been left for so many years? !
"How old was the patient when she gave birth to her last child?" Xu Qiu asked.
The family members were stunned for a moment. They did not expect the doctor to ask such a question.
"She is already 76 years old... The last time should be my younger sister. My mother gave birth when she was 42 years old. It has been 34 years." After thinking for a while, the family members answered honestly.
34 years?
This time it was Xu Qiu's turn to be stunned.
"Let's do a few tests first." He immediately made arrangements.
It is almost impossible to do a detailed physical examination now. The patient cannot cooperate when he is not conscious. Forcing the examination will cause new damage.
In addition to the basic blood routine and liver and kidney function, Xu Qiu also arranged an abdominal CT enhancement, vascular color Doppler ultrasound, as well as EEG, cranial CT, etc.
The wound on the abdomen is one aspect. The patient also has signs of epileptic seizures, and organic diseases of the brain must be ruled out.
In other words, the brain lesions must be further clarified.
...
After admission to the hospital, Xu Qiu also saw the patient's information.
Pang Honggu, female, 76 years old.
Five months ago, she fell and fractured her right femoral neck. After being bedridden, she developed a sacral ulcer. She had a history of hypertension and cerebral infarction.
Of course, this was only the problem found during this hospitalization.
Pang Honggu's family also brought the medical records from the local hospital.
For example, half a year ago, the patient began to experience abdominal pain without obvious trauma or overeating. At first, it was around the umbilicus and persistent dull pain in the upper abdomen, accompanied by worsening colic, etc.
Vomiting occurred, and the vomitus was gastric contents, not in the form of a jet, and there was no coffee-like substance or blood clots.
After a detailed examination of laboratory indicators and B-ultrasound, it was initially determined that it should be acute appendicitis.
It is worth mentioning that the diagnosis at that time mentioned the active crater in the patient's abdomen, which was defined as "infection of the inverted T-shaped incision of cesarean section."
The local hospital has taken measures, such as changing the dressing, re-doing the second stage suture, etc.
But the wound continued to crack, since infection and exudation occurred.
However, the family did not seem to notice these details, so when Xu Qiu asked about the patient's abdominal condition, the family looked confused.
When the family members saw the huge wound on Pang Honggu's abdomen, they were even more shocked.
…
Read on.
The local hospital diagnosed it as acute appendicitis. There was no obvious mass echo in the appendix area, but there was a small nodule in the right kidney and a cystic nodule in the right appendix area. The abdominal standing DR did not find signs of intestinal obstruction and gastrointestinal perforation.
At that time, tramadol was given intramuscularly for pain relief, and the abdominal pain was temporarily relieved, but it soon recurred again.
So it was switched to intramuscular injection of dezocine and intramuscular injection of scopolamine.
However, the result was still the same, the abdominal pain was temporarily relieved, and then it worsened again.
Moreover, the reason why the patient was transferred to the hospital was not the "sacral ulcer" mentioned many times by the family members. In fact, the fundamental problem was the severe abdominal pain caused by suspected acute appendicitis!
Seeing this, Xu Qiu broke out in a sweat on his back.
Fortunately, he was a cautious person and never took the descriptions of the family members or the patients themselves as the focus, but only as an auxiliary for his own physical examination.
If another doctor had really believed the family members, the patient would have died without knowing how!
The family members did not pay attention to the more important abdominal pain, but subjectively believed that the huge ulcer in the sacrum and coccyx was the key.
In fact...
The cut on the sacrum and coccyx is just scary, it won't endanger life in a short time.
What's more deadly is the severe abdominal pain that needs to be checked!
Xu Qiu quickly got up and went straight to Pang Honggu without waiting for other test results.
Pang Honggu was still a little confused at this time and couldn't finish the answer.
But at least she could do a simple physical examination.
At this time, Xia Zhu, the nurse in charge of nursing, came to report.
"Doctor Xu, the patient vomited twice just now."
"Dry retching?"
"Yes, there should be nothing in her stomach."
While nodding, Xu Qiu picked up the stethoscope, bypassed the wound on the umbilicus, and pressed it on the patient's abdomen.
Active bowel sounds...
Combined with the patient's previous performance, acute appendicitis cannot be ruled out, but the patient must have acute gastritis.
"First, do symptomatic treatment of anti-inflammatory, stomach protection, and antiemetic."
"Use metoclopramide."
After Xu Qiu gave the doctor's instructions, he returned to the office.
This physical examination still did not obtain any new information, so we can only wait for further test results.
As the get off work was about to end, Xu Qiu clicked on Pang Honggu's page again.
A lot of examination reports popped up.
The first one was the cranial CT.
Xu Qiu had previously suspected that Pang Honggu had an organic brain disease, so he focused on doing an EEG and cranial CT.
However, apart from the old lesions of cerebral infarction, he did not find any new abnormalities.
Brain tumors, vascular malformations, brain edema, etc. did not exist at all.
As for the EEG, although there were abnormalities, there were no specific manifestations, suggesting diffuse abnormal activity.
This result did not have much clinical significance.
