Chapter 2618 【2618】Bleeding

Aortic aneurysm and aortic dissection are usually difficult to detect clinically, so it is too late for most patients to go to the hospital for treatment.

Junior sister is amazing. Another thing that is the most powerful little junior sister is a tendon. Huang Zhilei sighed.

See, when everyone was thinking about what to do with this pit, Xie Wanying stood in front of the light board and kept studying the MR film.

Duan Sanbao stood behind her, watching the movie with her.

It may be that the two of them discussed the patient's case in the afternoon, and it was time to quarrel. Now watching the film, silence is golden.

The other teachers and bosses were bombarded by the patient's serious illness information, and their brains were a little stimulated, and they stood by and argued endlessly.

"In a coma. This MR film is definitely not accurate. If you take another picture, the dissection should be torn to the innominate artery or the left common carotid artery."

The innominate artery and the left common carotid artery have been mentioned before. They are branches from the aortic arch and connect to important cerebrovascular trunks. It can be said that if there is any problem with these two blood vessels, the brain tissue will be deprived of blood nutrition. Cerebral ischemia caused the patient's consciousness to be disturbed, and the direct clinical manifestation is that Axi's mother is now unconscious.

How does aortic dissection cause the innominate artery and left common carotid artery to "break off blood"?

Here are some other characteristics of aortic dissection. It is similar to aortic aneurysm: it is afraid of bleeding like a balloon bursting. A hematoma that forms a large ball compresses nearby organs and tissues. For example, compression of the nearby esophagus can cause dysphagia, and compression of the superior mesenteric artery may lead to intestinal necrosis.

However, it is obvious that it is not the reasons mentioned above that aortic dissection can widely cause various "blood-severing" symptoms of organs. The obvious difference between aortic dissection and aortic aneurysm is that the adventitia is not broken, and the blood runs into the dissection.

There is blood in the dissection, which will squeeze the original true lumen of the blood vessel, causing the blood flow in the true lumen to drop sharply. The most intuitive clinical manifestation is the difference in blood pressure between the two limbs of the patient. There is less blood in the true lumen of the extremity on the side that is compressed by the dissection, resulting in low blood pressure measured.

To put it more deeply, low blood pressure is definitely not a good thing. Anyone who studies medicine knows that this means that a certain part of the body is ischemic.

This is indeed the case, even if the blood does not seem to be lost in the dissection, in fact, after this part of the blood runs to the dissection, less blood flows into the true lumen of the vessel. The dissection is false, not a true blood vessel. It does not connect to the main blood vessels of the organ. Blood needs to go from the true cavity to the organ for nourishment. The blood that went to the interlayer slipped away and failed to reach the organs. This will cause the blood vessel segment with dissection to "break off blood". As long as the main vessels supplying blood to other organs are related to this dissection vessel, they will all be "cut off the blood". These organs are naturally in a state of ischemia, which is also called poor perfusion and hypoperfusion in medicine.

For example, if one or both renal arteries are involved, the patient will suffer from renal failure if there is severe anuria and hematuria.

Involvement of the celiac artery may lead to irreparable consequences of hepatosplenic infarction.

The arteries of the lower extremities are involved, ranging from chills to severe pain and necrosis. This is why Aki's mother's limbs are cold.

If the spinal cord is "broken", symptoms may appear in the corresponding spinal cord segment, ranging from lumbar pain to paraplegia.

The left common carotid artery of the innominate artery mentioned above was "pinched", and central nervous system symptoms appeared.