Chapter 1116 [1116] Surprising Complications
"Did the patient have a heart attack?!" Dr. Ma said in surprise, "Impossible. The patient was monitored by ECG, and there was no obvious abnormality in the ECG."
If it's really a heart attack, get an electrocardiogram to find out, and he on duty won't be able to see it and call the professor.
"No." Xie Wanying shook her head, "I mean, I'm afraid it's not the patient's original disease that caused this situation, but the complications after endoscopic treatment."
"What complication did you say?" Fang Xueqing and Dr. Ma anxiously wanted her to explain clearly.
This is related to the technical issues of internal medicine, and it is very serious. Besides, endoscopic treatment is much safer than surgical treatment. The most terrifying complication of endoscopic treatment should be massive bleeding or perforation. However, the current symptoms and signs of patients do not support the occurrence of these two serious complications.
Xie Wanying said, "It's a pulmonary embolism."
Fang Xueqing and Dr. Ma stared at her blankly for a while, and then looked at each other. They, as gastroenterologists, had not heard of this complication.
"There are papers that have reported such cases." Xie Wanying told them.
"Professor Fang?" Dr. Ma asked Professor Fang, completely unable to make up his mind. Pulmonary embolism is extremely rare in the clinical department of gastroenterology. As a young man, he has never seen it before, so he can only ask the professor if the patient's symptoms can be suspected as pulmonary embolism.
Fang Xueqing frowned, as if she had never seen a pulmonary embolism in her memory. She is a doctor in gastroenterology, not respiratory medicine or cardiothoracic medicine.
Most importantly, this extremely rare case after gastroenterology endoscopy can be published as a special case report in a journal article. But it is indeed too rare to be inferred clinically at all. It can only be used as a reminder that clinicians may need to pay attention to the existence of such special cases.
How can I be sure that what Xie Wanying said is not a guess made out of random imagination in a paper? Some medical students who like to do research papers and leave the clinic are like this. They are immediately suspicious when they see similar cases in the clinic. In the eyes of clinical teachers, this kind of medical students seems to deliberately show their talents and show off their skills, so clinical teachers don't like it very much.
Guessing is fine, but evidence is needed to support it. Guessing rare cases means patients need extra testing. All costs are borne by the patient and the patient's family. If the suspicion is wrong, the money is a waste. Once a medical dispute arises, the patient's family will use this to attack the doctor. Now this patient, the patient's family members are already dissatisfied, and then give the patient a random examination? Fang Xueqing frowned so much that she couldn't untie it. Dr. Ma was waiting for her decision, sometimes looking anxiously at the family members outside.
"Doctor Song." Fang Xueqing asked Song Xuelin's opinion again.
Song Xuelin said: "Do as Dr. Xie said."
A look of surprise flashed across Fang Xueqing's eyes: "Do you support her opinion, Doctor Song?"
Dr. Ma was more anxious than anyone else, and asked anxiously, "If you suspect pulmonary embolism, what tests do you need? Should you send me for CT right away?"
Their subjects are too rare, and it is easy for doctors to suddenly forget the relatively remote knowledge points in textbooks.
"You can try a blood gas analysis first." Xie Wanying suggested, "The cost is not high, and the results are quick. In the case of acute pulmonary embolism, the patient's body is hypoxic and oppressed. The blood gas analysis typically shows that the blood carbon dioxide and blood oxygen levels are high." Low. This kind of inspection report can be said to distinguish many diseases, and it can be regarded as an important reference indicator. After the data is supported, consider doing other inspections for further confirmation.”