I can see the status bar

Chapter 789 Painless Pancreatitis (Blood Donation Plus Series 030)

Back in the emergency room, Sun Li'en continued to carry out various rescue measures while issuing a new doctor's order.

"Urgently check blood amylase and urine amylase?" After hearing Sun Lien's doctor's order, the nurses rarely stopped their work and reconfirmed, "Are you sure?"

"Sure." Sun Li'en nodded and added, "Push B over and give her a pancreas color ultrasound."

"Is she diabetic? She looks like type [-] at this age." Yuan Pingan saw the abnormal behavior of the nurses from a distance, and he rushed to the scene immediately after paying attention to the situation here.After hearing Sun Lien's words, he was also a little puzzled, "There is no history of trauma, and there is no Cullen's sign, why is there pancreatitis?"

Cullen's sign is a special superficial symptom of acute hemorrhagic necrotizing pancreatitis.Necrotic and bleeding pancreatic necrotic tissue is mixed with pancreatic juice, enters the subcutaneous fat layer along the interstitial space, and then begins to digest the fat, which in turn leads to capillary rupture and bleeding.Thus forming a special manifestation of large bruises on the abdominal skin.

Cullen's sign does not necessarily appear in all cases of acute pancreatitis, but all Cullen's signs mean that the patient has severe acute pancreatitis.

Trauma is another high risk factor for acute pancreatitis.After the pancreas is injured, the pancreatic duct ruptures and the pancreatic juice overflows, which can easily lead to acute severe pancreatitis.

In the absence of self-reported severe epigastric pain, these two conditions are the main factors for emergency physicians to determine whether a patient may have pancreatitis.Yuan Pingan didn't find anything related to these two factors, so naturally he couldn't figure out why Sun Lien thought the patient might have pancreatitis.

Because the status bar indicated that pancreatitis occurred earlier than all other symptoms, of course Sun Lien couldn't say it.But he also has his own set of perfect theories.He showed Yuan Ping'an the receipt for the drug purchase he had received, "The patient himself has a high-sugar and high-fat diet, and he bought these drugs from the pharmacy the day before the onset of the disease."

Yuan Pingan took the list and looked at it, "These are all gastrointestinal medicines..."

"Obviously, they were all recommended to her by the clerk of the pharmacy." Sun Lien explained, "The clerk of the pharmacy couldn't determine the cause of her discomfort, so he also recommended to her that it could treat digestive tract diseases based on his own 'experience'. Medicine for ulcers and indigestion.”

Yuan Ping'an suddenly realized when he heard this, "So she had the problem of upper abdominal distension and pain before."

It's easy to talk to smart people.Sun Li'en nodded happily, "The problem of upper abdominal pain is actually a symptom of pancreatitis."

"Isn't that right?" The nurse next to me was puzzled, "All the pancreatitis patients I've seen are in so much pain that they are almost out of shape. This kind of pain that can buy medicine by yourself is definitely not as good as acute pancreatitis." It hurts so much."

"Not all cases of acute pancreatitis will cause severe pain." Yuan Pingan explained, "There is a special type of acute pancreatitis called 'painless pancreatitis'. In the past, this disease was also known as 'sudden death pancreatitis'. pancreatitis'."

The reason why painless pancreatitis has such a chilling name is mainly because it is really special.Patients have no symptoms in the traditional sense, so it is difficult for doctors to detect its existence before the patient dies.The diagnosis of such cases is often confirmed by autopsy after the patient dies from the disease.

Painless pancreatitis is not completely painless.In fact, they still bring a series of uncomfortable feelings including upper abdominal pain, flatulence and so on.But therein lies the difficulty in diagnosing the disease—very few doctors associate pancreatitis with the symptom.Patients don't think that they have any serious diseases, and they often choose to ignore or take their own medicine to try to relieve symptoms.So that when patients with painless pancreatitis are sent to the hospital, it has often been delayed for a long time.When the doctor finds out, their symptoms will be much worse than ordinary acute pancreatitis patients.It is very difficult to treat such patients.

Zeng Jing was lucky, her painless pancreatitis did not directly drag her into the abyss of death.The usual high-sugar and high-fat diet saved her life to some extent—because of the outbreak of painless pancreatitis, the insulin content in Zeng Jing's body dropped rapidly to an unacceptable level.And such insulin content is obviously unable to cope with the high-sugar and high-fat diet she is used to.After drinking four times the milk tea for two consecutive days and eating a normal diet, Zeng Jing's blood sugar levels soared all the way.And the blood sugar was too high and it affected her body's ability to use blood sugar.A large amount of fat begins to be broken down into ketone bodies, which finally causes ketoacidosis.

A hyperosmolar coma from ketoacidosis and hyperglycemia landed her in the emergency room.And in the emergency room, there happened to be Sun Lien who was extremely bored and was looking for something to do.

This series of links are connected end to end, and the lack of any one of them may lead to fatal consequences.And when all these conditions were closely combined, Zeng Jing walked a tightrope in countless death traps and encountered a safe road that could save her life.

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Because the location of the pancreas is too deep, the color ultrasound examination of the pancreas was performed by a sonographer who was invited to the emergency room for consultation. He frowned and looked at it again and again, and then said, "This pancreas is very edema...acute pancreatitis The possibility is very high, but it is really not easy to see clearly by ultrasound, it is best to get a CT scan."

Sun Li'en nodded, and then issued a brand new doctor's order, "Physical saline mixed with 100 mg of gabexate mesylate, instilled in two hours. Somatostatin 250 micrograms, injected in 3 minutes."

The nurses turned their heads to dispense the medicine, while Sun Li'en fell into a new entanglement.Should Zeng Jing be sent to the CT room for examination immediately, or should she wait until her acidosis is slightly relieved and her vital signs are relatively stable?Or send the person directly to the operating room and perform abdominal lavage on her urgently?
After thinking about it for a while, Sun Lien immediately decided to take the fastest and most decisive measures to intervene.Different from ordinary acute pancreatitis, the reason why painless pancreatitis is also called sudden death pancreatitis is naturally because it is more dangerous.Phospholipase A released from pancreatic tissue in patients with sudden death pancreatitis decomposes lecithin into lysolecithin, thereby inducing ARDS (acute respiratory distress syndrome) and pulmonary embolism.The myocardial inhibitory factors released by pancreatic necrosis can lead to acute heart failure. Once pancreatic necrotic blood stimulates the solar plexus of the abdominal cavity, it is more likely to cause reflex heartbeat inhibition, resulting in cardiac arrest.

The use of conventional acute pancreatitis drugs alone may not be effective before these fatal consequences occur.More drastic measures must be taken immediately so that it is possible to turn the situation around before symptoms appear.

Sun Li'en walked out of the emergency room again. This time, what he needed was not clues, but direct authorization for endotracheal intubation and emergency surgery.

　The blood donation increase mentioned before has not been systematically increased, so now we will start to increase the increase.It is not easy to count the previous additions, so let’s count it as 30 for the time being, I hope everyone has no comments (even if there is, it seems that it is not convenient to change it...)
　　I will count the corresponding addition list as soon as possible, and then put the ID of the friend who donated blood into it.Once again, I would like to express my highest respect to all the readers who actively donate blood - thank you for your kindness, every drop of blood you donate may save a life.

　　
　
(End of this chapter)