I Can See Health

   Chapter 423 Confused

  The guide wire poked the heart, causing the heart to accumulate fluid?

   Lu Chen's expression froze, and he immediately rejected his idea.

  The entire guide wire entered the heart vessel without any accident, and his movements were very gentle, and he would not poke the heart at all, causing such a serious complication.

   On the other hand, Lu Chen is very confident in his intervention skills.

  In the system to simulate the operation of the guide wire in the blood vessel, he has tried hundreds of thousands of times, and this serious complication has never occurred.

   However, the health value on the patient's head is 68 (--), and there are two minus signs, indicating that the patient's state is developing further and may become worse and worse!

   Xiao Shikang frowned deeply. He also felt that this kind of pericardial effusion did not seem to be caused by surgery.

   "Lu Chen, stop the operation first." Xiao Shikang said.

"it is good."

   After saying this, Xiao Shikang immediately walked out of the catheterization room, took off the lead coat, and immediately contacted the ward doctor.

  Lu Chen first pulled out the guide wire, then sterilized the patient's operating area, and after a little bandage, went to the catheter room.

   "I asked the ward doctor to bring his medical records." Xiao Shikang frowned, "By the way, when you visited the patient yesterday, did he have any abnormality?"

  Lu Chen shook his head, "No."

   When Lu Chen went to the fifth district in his heart yesterday, the patient was in the ward, talking and laughing with others.

   "That's weird." Xiao Shikang wondered, "Is there a heart ultrasound examination before surgery?"

   "I had a heart ultrasound done a month ago in our hospital." Lu Chen said, "So I didn't do it again before the operation this time."

   Heart ultrasound, under normal circumstances, there will not be much change within a month,

   "Why did you suddenly have pericardial effusion?" Xiao Shikang muttered to himself.

   At this moment, the doctor from the ward of the fifth district in the heart came down, and he brought all the examination materials of the patient.

  Lu Chen and Xiao Shikang immediately started to read.

  The two immediately noticed a strange place. In the past week, the patient suddenly felt tired of oil and stomach discomfort.

   "Mr. Xiao, I'll go get the ultrasound." Lu Chen immediately said, "I'll do a heart and abdominal ultrasound for the patient."

   "Okay!" Xiao Shikang nodded, he almost forgot that Lu Chen had this skill.

  …

  Lu Chen came to the CCU next to the catheterization lab. After borrowing the ultrasound machine, he returned to the catheterization lab.

   "Uncle, don't be nervous, I'll give you a check."

  Lu Chen put on the gloves again and comforted the patient: "It will be fine soon."

   On the operating table, the patient was a little nervous. The sudden termination of the operation made him feel quite overwhelmed, "Doctor, doctor, what's wrong with me? Why didn't the operation happen?"

   "No big problem." Xiao Shikang said on the side, "I read the medical record and it says, have you suddenly felt anorexia in the last week?"

   The patient was stunned for a moment, then nodded, "Yes."

   "Has this been the case before?"

"No."

   The patient shook his head.

   At this time, Lu Chen had already held the ultrasound probe and placed it on the patient's heart.

   "Minor-moderate pericardial effusion."

The    probe is placed on the heart, and the image is immediately displayed on the ultrasound machine's screen.

   Normal people have a small amount of pericardial effusion, but this patient's pericardial effusion is obviously much more.

  Lu Chen immediately looked at the patient, "Uncle, do you feel chest tightness and shortness of breath?"

   "No." The patient shook his head in denial.

  Lu Chen frowned deeply. If the pericardial effusion appeared suddenly, or appeared during the operation, and a small to moderate amount of pericardial effusion appeared in such a short period of time, there would definitely be symptoms of chest tightness and shortness of breath.

   But the patient does not have any abnormality now.

"That explains a point!" Lu Chen's eyes were burning, "These pericardial effusions did not appear suddenly. However, the patient's echocardiography a month ago was normal, so these pericardial effusions appeared slowly within a month. "

   "Well, it makes sense." Xiao Shikang nodded in agreement.

   "I'll continue to see his abdominal ultrasound." Lu Chen said.

   "Can you do abdominal ultrasound?" Xiao Shikang asked in surprise.

  As a cardiologist, he is good at heart ultrasound, but when it comes to abdominal ultrasound, he is blind in both eyes.

   "I will make a million points." Lu Chen smiled.

   There is a cheating device such as a systematic simulation space. In addition to cardiac ultrasound, Lu Chen naturally also trained other parts of the ultrasound.

   Among them, the abdomen, chest, etc., which are closest to the heart, are his key training parts.

  Lu Chen changed the ultrasound probe and reapplied the couplant (the medium for ultrasound imaging).

  The probes for a cardiac ultrasound and an abdominal ultrasound are different.

  The probe of cardiac ultrasound is small and narrow, but the probe of abdominal ultrasound is much wider than that of cardiac ultrasound.

   "Professional!" Xiao Shikang's eyes lit up, seeing Lu Chen's actions, he had to sigh.

   Soon, an image of the abdomen appeared on the ultrasound machine.

   However, the video image displayed next to them made both of them a little confused.

   "This is... peritoneal effusion?!" Lu Chen asked in surprise.

  Things became more and more confusing.

   In addition to pericardial effusion, the patient also has ascites!

   "How come there is peritoneal effusion again?" Xiao Shikang was also confused at this time. He remembered that the patient had an abdominal CT before the operation.

   Abdominal CT is normal!

   The abdominal CT was done two days before the operation, that is to say, the patient's ascites appeared suddenly within one or two days!

   "Besides the ascites, the patient's liver occupies a large space!" Lu Chen pointed to the image on the screen.

   "Cyst?" Xiao Shikang said, "Could it be that the liver cyst ruptured and bleeds, causing ascites?"

  Lu Chen shook his head, "I don't know the nature of the hepatic mass, but if the rupture of the liver capsule is used to explain the ascites, how should the pericardial effusion be explained?"

  Medicine emphasizes "monism", and finally uses one disease to explain multiple symptoms.

  If the patient's ascites is caused by ruptured liver cyst, what about pericardial effusion?

   Even if the liver cyst splits and bleeds, it is unlikely to cause pericardial effusion!

   At this time, Lu Chen took off the ultrasound machine and began to examine the patient's abdomen.

   There was so much peritoneal effusion suddenly. Although the patient did not have any symptoms, he could not have no abdominal signs.

   The patient's abdominal skin was exposed, and Lu Chen began to perform an abdominal examination.

   Physical examination is divided into sight, touch, percussion, and hearing.

  Lu Chen now mainly performs palpation.

   "Does it hurt?" Lu Chen carried out a palpation from shallow to deep.

   The patient did not have any symptoms at first, but as he progressed from the shallower to the deeper, he began to feel it.

   "It hurts, it hurts a little!"

  Lu Chen stopped immediately and could no longer carry out the inspection.

   If the liver mass ruptures and hemorrhages, then the trouble will be big!

   "Mr. Xiao, contact the CT room immediately." Lu Chen said quickly.

   The patient is currently in this condition, and the most important thing is to determine the diagnosis.

   Just relying on the ultrasound image at the bedside is not enough!

   (end of this chapter)