Diagnose again

According to the description of the patient's family and the diagnosis brought by other hospitals, there is no problem.

The patient ate a little seafood two days ago, and had abdominal pain and vomiting that night.

She got better after she had an examination at the hospital and some water was hung. After all, the patient is a pregnant woman, so she must be very careful in the treatment so as not to hurt the child.

As far as the patient's current reaction and physical examination are concerned, gallbladder or gastrointestinal disease is most likely.

The following tertiary hospitals have not found out, so it depends on their inspection results.

"It hurts to death~It hurts so much~"

On the hospital bed, the woman tossed and turned in pain, her face pale as paper.

The pain seems to be getting worse, but nothing can be done right now.

Outside the rescue room, Han Xiaoxiao finished asking in detail, opened the door and walked in with a frown.

"Doctor Han, the patient has fainted!"

At this moment, the nurse suddenly shouted.

Han Xiaoxiao's heart tightened when he heard the words, and he rushed over to quickly check the woman's heartbeat and pupils.

"Intravenous infusion of normal saline and glucose."

The test results have not yet come out, the patient's vital signs are still stable, it should be fainting caused by excessive pain,

"Notify the Department of Gastroenterology and Obstetrics and Gynecology to come for consultation."

Soon, the IV was put on, and the doctors from the obstetrics and gynecology department and the gastroenterology department rushed over after receiving the news of the emergency.

After learning about the patient's situation, the two looked at each other in blank dismay.

They had never heard of this kind of pain, and the inspection reports they gave were all brought over from other hospitals.

"Doctor Han, the test results are out."

At this time, the doctor from the laboratory trotted over and handed all the inspection reports in his hands.

Han Xiaoxiao quickly took it, and the three doctors started consultations at the same time.

However, after a few minutes, all three of them froze.

All test results are normal!

"How is this going?"

The gastroenterology doctor was dumbfounded and said to himself.

Through B-ultrasound and contrast imaging and related inspections, all indicators are normal!

The patient also showed no signs of food poisoning, and the test results were all consistent with the test reports from other hospitals.

All normal!

"Doctor Han, this..."

The obstetrician was also helpless.

Wow~

Just when the three of them were at a loss, the woman suddenly opened her eyes and sat up abruptly.

The situation startled them, but they calmed down immediately.

"How are you? Is it still hurting?"

Han Xiaoxiao walked to the woman and asked.

…

The woman's expression was a little stiff, and she just looked at her when she heard what she said, but didn't speak.

Seeing this, Han Xiaoxiao felt something was wrong, so he raised his voice and asked twice.

Still nothing happens!

The woman's pupils dilated and contracted, and her mind seemed to be in a trance, as if she didn't hear it.

"Could it be pregnancy syndrome?"

Seeing this, the female doctor in the obstetrics and gynecology department couldn't help but wonder.

Pregnancy syndrome may include depression and minor nervous disorders due to emotional anxiety, resulting in trance.

This is medically possible.

"Hiss~ It hurts!"

Suddenly, the woman seemed to come to her senses, clutching her stomach and crying out for pain again.

Han Xiaoxiao and the others were completely dumbfounded, and their expressions became more dignified.

Can't find out the cause, there is no way to solve it!

"There is no abnormality in the B-ultrasound, the liver and gallbladder are also frequent, and there is no pelvic effusion. How about a gastroscopy?"

The gastroenterologist asked with a frown.

"Could it be a cornual pregnancy?"

At this moment, the obstetrician and gynecologist pondered.

Cornual pregnancy, a special kind of ectopic pregnancy, is a pregnancy in which the embryo is implanted in the uterine horn close to the junction of the uterus and fallopian tube opening.

There are generally three types of cornual pregnancy.

One is that the gestational sac stops developing and miscarriage occurs;

The second is that the gestational sac expands outward at the uterine horn and eventually causes the uterine horn to rupture;

The third is that the expansion of the blank fetus to the uterine cavity is delayed until the late stage to achieve a successful delivery, because the muscle tissue of the uterine horn is weak, and it is also the anastomosis of uterine blood vessels, ovarian arteriovenous and fallopian tube blood vessels, with rich blood supply.

The gestational sac is planted here, and as the pregnancy progresses, the base layer may rupture and the bleeding will increase. If the diagnosis is delayed, it may be life-threatening.

If it is really a cornual pregnancy, combined with the woman's current situation, it is likely to be the third type.

Moreover, once the pregnancy reaches the second trimester, the B-ultrasound is difficult to find out.

Hearing her words, Han Xiaoxiao and the gastroenterologist changed their expressions.

If it is really a cornual pregnancy, it is very likely that the uterine wall is ruptured, and even life-threatening.

It is necessary to flow people in advance!

"Why don't you have a gastroscopy to rule it out?"

The gastroenterologist then suggested.

"I agree."

The obstetrician and gynecologist nodded.

First rule it out, if it is really possible, you need to investigate it.

After all, the patient is now in the second trimester of pregnancy, and CT cannot be easily performed if the diagnosis cannot be made.

"How about I ask the director to take a look?"

Han Xiaoxiao was a little hesitant, and said in embarrassment.

Hearing this, the other two doctors nodded.

It is best to have a leader at this time, and this is an emergency department, of course the leader on duty in the emergency department.

After finishing speaking, Han Xiaoxiao walked quickly to the office.

"Director Qin, can you take a look? There is a patient who is very troublesome, and the cause cannot be found."

Qin Feng raised his head when he heard the words, then got up and asked.

"What's the patient's condition?"

"The patient is a female, 35 years old, 16 weeks pregnant, and suddenly developed abdominal pain. She has been checked in other hospitals and found no problems, so she was transferred to us."

Han Xiaoxiao quickly explained the situation,

"We conducted a detailed inspection, but all the results were fine, B-ultrasound, blood routine..."

The two talked while walking, and after listening to all the process, Qin Feng also showed a surprised expression.

Can't find the cause?

The obstetrics and gynecology suspected cornual pregnancy.

If it is true, then there is indeed some trouble!

"Ouch~"

In the rescue room, Qin Feng watched the woman on the bed clutching her swollen stomach, sweating from the pain.

"Don't move, I'll check it out for you."

He put on his stethoscope and reassured the woman as he spoke.

"Does it hurt? Why does it hurt?"

…

After a simple physical examination, Qin Feng picked up the examination report and went through it.

There was no abnormality in the examination, excruciating pain in the abdomen, and a trance...

This situation is difficult to judge!

Abdominal pain is the basic symptom of a large number of diseases, such as various acute abdomens, including kidney stones, gallbladder and common bile duct stones, acute pancreatitis, gastric or duodenal ulcers, acute appendicitis, intestinal obstruction, etc.

If you don't know the cause, you can't determine the treatment plan at all.

And his examination also confirmed that it should have nothing to do with the patient's digestive system.

Then the rest is the cornual pregnancy proposed by the obstetrics and gynecology department.

But before this check, you still have to rule out everything that can be ruled out!

"In this way, check the PAS, blood biochemistry, and do a urine test for PBG and ALA. Let the laboratory department expedite it, and let the neurology doctor come over."

Qin Feng thought for a long time, and did what he needed to do, so he started from other aspects to see if he could find clues.

At this moment, he is also constantly sorting out and excluding in his mind. Based on the patient's age, life status, recent situation, examination status and other factors, he sorts out the most likely symptoms of abdominal pain.

Among them, three diseases were quickly locked on.

Collateral reaction caused by pathological neuropathic pain, rare acute porphyria, acute biliary tract disease.

Be the first to do an inspection!

Biliary tract problems require CT, which cannot be done now.

Neurological problems should be judged by neurologists, and porphyria is a rare disease that most people would never think of.

But precisely acute asymptomatic abdominal pain is a sign of acute porphyria!

The most important thing is that when Qin Feng checked the woman, he found an unexplained nervous system dysfunction, especially the partial muscle weakness and stiffness in the arms and legs.

He guessed that the woman's current situation, if not for neurological problems.

That is likely to appear in the blood and biliary tract!