Doctor Peerless

Chapter 627 Rare Diseases (Supplement 2, over!)
In front of Zhou Sheng's eyes, the black panel with a sense of technology appeared.

The patient's physiological indicators are clear.

Age: 18 years and 215 days.

Height: 187CM.

Weight: 68KG.

Heart rate: 103 beats/min.

Blood pressure: 156/105mmHg.

Alcohol content: 85mg/100ml.

Current symptoms: oppressive chest pain, dyspnea.

……

These data were scanned by Zhou Sheng, and most importantly, Zhou Sheng had to look at the cause given by the system.

Zhou Sheng continued to look down.

……

Condition: Pneumomediastinum

Etiology: Spontaneous esophageal rupture.Severe vomiting after drinking alcohol and a full meal is caused by the pressure difference between the inside and outside of the esophageal wall caused by negative chest pressure, and the muscular layer of the lower esophageal wall is torn.

It turned out to be the disease.

Zhou Sheng suddenly realized.

Spontaneous esophageal rupture refers to the sudden occurrence of full-thickness esophageal rupture in healthy people. Because most of them occur after drinking and vomiting, some people call it post-vomiting esophageal rupture.

This condition is clinically rare.First described by Dutch physician Herman Boerhaave in 1724, it is also known as Boerhaave syndrome. The patient was an admiral who ruptured his esophagus after eating too much and vomiting.This disease is more common in young men.

As for why general vomiting can cause spontaneous esophageal rupture.Under modern medical cognition, there is no definite statement.

This condition is a very rare clinical problem.

According to relevant statistics, there is only one case in about every 75 hospitalized patients.

Because it is so uncommon, the misdiagnosis rate can be as high as 80%.

Take a large tertiary hospital like the Central Hospital as an example, there may not be one case in a year.

The clinical fatality rate of the disease is more than 10%, and with the delay of diagnosis, the fatality rate will gradually increase.

The best solution to this disease is surgical intervention.
In addition to exhausting the pneumomediastinum caused by the rupture of the esophagus, drainage of the chest cavity is also required. If the rupture of the esophagus is relatively large, the esophagus must be repaired surgically.

It is clear that this is the disease.

Zhou Sheng already had a well-thought-out plan on how to check.

Bai Mingming and Liu Zhengqing suspected that the patient had acute pancreatitis just now, so they proposed the identification of upper abdominal color Doppler ultrasound and urine amylase.

This is completely useless for the determination of spontaneous esophageal rupture.

The site of disease is in the esophagus.

The main symptoms are all in the chest. If you do a chest CT, you will see the problem immediately.

Of course, Zhou Sheng couldn't directly say the judgment given by the system.

Still have to check step by step.

However, Zhou Sheng can use his influence to move the inspection in the right direction faster.

Zhou Sheng made a decisive decision: "In addition to abdominal color Doppler ultrasound, let's do a chest CT."

Bai Mingming thought that Zhou Sheng had done a chest CT to see if the patient had the possibility of pneumothorax.

So he said: "Group Leader Zhou, Dr. Liu and I have heard about his lungs just now, and there is nothing wrong with it. The possibility of spontaneous pneumothorax is not high."

Zhou Sheng insisted: "Anyway, so many checks have been done, and there is not much more. Since it is chest pain, let's have a good chest check."

Speaking of this, Zhou Sheng looked at the wall clock on the wall, and continued: "There are relatively few people doing the inspection at night. It is estimated that after the inspection, we have not finished get off work yet."

Liu Zhengqing said at this time: "After so many tests, the cause of the disease has not been found out. Will the family members have any opinions at that time?"

Zhou Sheng said: "Human life is at stake, this family member will definitely understand. I will be responsible for explaining the situation to them."

Zhou Sheng is no longer a small intern.

In terms of status, he is the leader of the four groups.

The person in charge of the emergency department in this group, if there is any dispute, he has to listen to it.

Moreover, Zhou Sheng's skills are obvious to all, and he also has prestige.

So Bai Mingming and Liu Zhengqing didn't talk any more.

Three tests will be launched immediately.

The nurse started to prepare the wheelchair.

At this time, Zhou Sheng fulfilled what he just said.

He walked to the door of the emergency room.

The boy's parents, who were waiting at the door, immediately huffed and surrounded him when they saw a doctor coming out.

The two asked questions in a hurry.

"Has the cause of my son's illness been found out?" the boy's father asked anxiously.

"Not yet, but after he comes out, he will do a few more tests, and I think the results will be available soon." Zhou Sheng said.

"There is still an inspection, are you all right? It's been more than an hour. I just had two inspections just now, and I need another inspection. Apart from the inspection, what will you do?" the boy's mother was dissatisfied.

"Please understand. His condition is quite special. But I guarantee that after this inspection, there will be results." With the help of the system, Zhou Sheng is naturally full of confidence.

Doctors' confidence is sometimes the most important signal for patients and their families.

The boy's parents also asked Bai Mingming the same question just now.

Bai Mingming's answer was obviously evasive.

The attitude is very unclear.

But this later doctor seems to have a plan in mind.

The boy's parents were relieved.

They subconsciously believed that Zhou Sheng must be a more powerful doctor who could diagnose his son's disease.

Of course, this is not because they are familiar with Zhou Sheng, but Zhou Sheng gave them hope.

talking room.

The boy was in a wheelchair and was pushed out by the nurse to be examined.

His parents no longer had time to pester Zhou Sheng, but followed in the nurse's footsteps and went together.

……

an hour later.

Twelve midnight.

It's time for the four groups to get off work.

Liu Jing, Li Weiwei, Su Quan and others came home from get off work.

in the emergency room.

Zhou Sheng, Bai Mingming, Liu Zhengqing, and Cao Xin have not left yet.

They are waiting for the boy to check back.

Bai Mingming looked at the time and said, "Group Leader Zhou, Group Leader Liu, it's time to get off work, you go first. I'll just stay here. The first group is also on duty. If you can't make it work, I'll go Find Wu Jianxing and Sun Zheng."

Naturally, Zhou Sheng would not leave.

Spontaneous esophageal rupture.

With such a rare case, when the report came in a while, he didn't feel relieved to hand it over to others.

I won't go, but others...

Zhou Yisheng looked at Cao Xin and said, "Cao Xin, why don't you go first. It's unreasonable to ask you to work overtime when you come to the emergency department on the first day."

Cao Xin came to the emergency room just to exercise himself.

If you want to get off work early, you might as well just stay out of your mind!

He immediately stated: "It's fine if I go back, I want to see what kind of disease this patient is, and study hard."

Zhou Sheng looked at Liu Zhengqing again.

Liu Zhengqing didn't speak, but he didn't intend to leave at this time either.

This patient was not taken over by him.Now off work again.If it was in the past, he must have patted his ass and left immediately.

But thinking that I will leave the emergency center soon, the words are good, people leave their names when they leave, and geese leave their voices when they pass.Seeing that no one wanted to leave, he was too embarrassed to leave first.

Zhou Sheng had no choice but to say: "Okay, since everyone is not leaving. Let's wait for the patient to come back together. It should be soon, depending on the time."

While Zhou Sheng was speaking, the nurse took a stack of reports and pushed the boy back to the emergency room.

……

(End of this chapter)