The hospital resident of liver and gallbladder rushed down for consultation and was dumbfounded after watching the movie.
The patient had severe pain in his upper abdomen and was rolling on the flat car. But the more I move, the more it hurts, and the more it hurts, the more I can't calm down.
"I'll check with the second line." Zhou Litao, the hospital manager, said, "I'll probably need emergency surgery."
Zhou Litao thought the same way. The patient had bile duct obstruction and severe upper abdominal pain, so emergency laparotomy was necessary. He estimated that conservative treatment would not be effective, and he did not dare to give analgesics casually, for fear that complications such as perforation would not be discovered.
Watching the patient rolling on the flat car, Zhou Litao felt pain. This was a terrible suffering.
"Okay, I'll find someone to take the patient to the ward with you." Zhou Litao said.
Then he put the B-ultrasound report and the upper abdominal CT film into a film bag and gave it to the chief resident of the liver and gallbladder. The two strode to the emergency room, preparing to send the patient to the hepatobiliary surgery department.
While waiting for the emergency laboratory test results to be reported back, the nurse in the emergency department had already placed a gastric tube and a urinary catheter on the patient, and left an intravenous channel in place. If you are preparing for surgery, it is enough to go back and prepare the skin. The efficiency of the emergency department is always so high.
Arriving at the emergency room, the patient was retching.
Zhou Litao briefly asked about the medical history before, but because the situation was too urgent, he didn't ask too detailed questions.
The patient is a 24-year-old college graduate who has just returned home from school and has just started looking for a job. Unexpectedly, I suddenly had a stomachache at night, and my family didn’t know the other details.
Vomit... Vomit... The patient was retching. Because the vomiting was so violent, the stomach and intestines were already empty, and only some acidic water could be vomited out.
She did not vomit blood, and no food was found in the vomit. Even after gastrointestinal decompression, the vomiting still did not improve at all.
The nurse was helping her tilt her head to prevent aspiration of vomit, which could lead to more serious complications.
"Give me your liver and gallbladder!" Zhou Litao said loudly and began to help push the flat cart out.
The flat car moved, as if it was related to the gastrointestinal tract. The girl poked her head out of the flat car and almost missed the door of the emergency room.
Zhou Litao quickly stopped the flat car, feeling frightened.
If this is an iatrogenic injury caused by a bump, then it's fucked up.
Vomiting... Before Zhou Litao's thoughts disappeared, the girl began to vomit more violently.
There was no gastric juice at this time, and she kept retching violently with tears in her eyes.
What disease is this? It didn't look like a stone. Zhou Litao was still thinking about the film while instructing the patient's family members to watch the patient carefully and avoid causing any trauma.
But the patient was holding on to the guardrail of the flat car, her body was convulsing, and she was vomiting violently. No matter how her family tried to persuade her, she kept her head outside.
Zhou Litao just wanted to have someone guard him so that he could send the patient to the hepatobiliary surgery department as soon as possible. Before he could speak, the liver-and-brain resident suddenly said loudly: "Wait a moment!"
"Mr. Chen, what's wrong?" Zhou Litao asked in surprise.
Mr. Chen strode to the gastrointestinal decompression front and picked up the negative pressure bottle.
Zhou Litao looked at it intently, then was stunned.
A bug was sucked out by negative pressure. Half of its body was in the pipe and the other half was struggling in the negative pressure bottle.
I go... What the hell is this? !
Zhou Litao is also well-informed, but seeing bugs during gastrointestinal decompression... I have never seen it before.
Mr. Chen's face turned green. He still had the phone in his hand and was communicating with Professor Yang on the second line. At this time, he immediately said: "I saw bugs in the patient's gastrointestinal decompression, white, about 6cm!"
"vomit..." The patient vomited violently and finally vomited something out.
Another yellow-and-white bug!
It’s just that there is no gastric juice, and the bugs are not spit out, but hang in the corners of the patient’s mouth, as if there are countless bugs in her body, crawling out...
"Professor Yang, there are also worms in the mouth..." Mr. Chen was also a little confused, "It looks like roundworms, yellow and white, like earthworms."
"Okay, I'll prepare for the operation right away!"
After saying that, he hung up the phone.
"Send away, send away!" Mr. Chen shouted anxiously, "Remove the liver and gallbladder and prepare for emergency surgery!"
Watching the group of people walking away and their backs disappearing around the corner, Zhou Litao still saw the image of gastrointestinal decompression and the squirming bugs that appeared in the innermost part.
If it's roundworms... Human ascariasis is a common parasitic disease caused by roundworms parasitizing in the human small intestine. The incidence rate is relatively high in children.
Adult roundworms are cylindrical, like earthworms; eggs are oval, and the surface of the egg shell is often attached with a rough and uneven protein film, which is brown due to bile staining.
Roundworms are common in children and less common in adults.
But as an adult, how can there be so many bugs "emitting" from them? Zhou Litao was a little confused.
"Mr. Zhou, what is that?" a young nurse asked while cleaning the emergency room.
"It looks like a tapeworm to me."
"Aren't roundworms all released in the feces? Why do they come out of the mouth in reverse flow?" asked the little nurse.
Zhou Litao shrugged, he didn't know what was going on.
Generally speaking, roundworms shouldn't be serious, so just take some anti-worming medicine. Legend has it that people who grind their teeth have roundworms, and eating a few pieces of intestinal worms will make them better.
This thing is not like a pig-headed tapeworm. It is rare to see a deadly one. It is just disgusting. Who is not afraid when they see bugs in their feces
"When I was browsing an online store a few days ago, I saw someone selling roundworm egg capsules. They said they were for weight loss. For extra money, they also got deworming medicine." The little nurse said with lingering fear: "At that time, I was thinking about buying some during my annual vacation. eat."
"Why do you dare to eat anything? That stuff is so disgusting." Zhou Litao scolded him with a straight face.
"Mr. Zhou, if you don't find a girlfriend, you don't know..."
With one sentence, Zhou Litao's scarred heart was stabbed viciously again. He didn't hear clearly what the little nurse said next.
"Why do you have to wait for the holiday?" Zhou Litao asked absently.
"It is said that one week after taking the roundworm egg capsules, you will have low-grade fever and general discomfort. Some people will also have nausea and vomiting. It seems that she is vomiting too much! It's a bit scary. I'd better think of another way. ." The little nurse quickly cleaned the emergency room and turned on the ultraviolet light to start disinfection.
Zhou Litao thought for a moment, picked up his cell phone, and called Mr. Chen from the Department of Hepatobiliary Surgery.
What the nurse in the emergency department just said was an important clue, otherwise there is no way to explain that there are so many roundworms that they "pop out" from the inside.
After hanging up the phone, Zhou Litao began to retrieve the patient's upper abdominal CT scan on the computer.
If the roundworms burrowed into the biliary tract, imaging would still support it. However, biliary ascariasis in adults is very rare, so Zhou Litao studied it bit by bit to enrich his clinical experience.