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Chapter 1116: 【1116】A surprising complication



  If he had a real heart attack, he would get an electrocardiogram to find out, how could he on duty not see it and look for the professor.

   "No." Xie Wanying shook her head, "I mean, I'm afraid it's not the patient's original disease that caused this, but the complications after endoscopic treatment."

   "What kind of complication did you say?" Fang Xueqing and Doctor Ma anxiously asked her to clarify.

   This is a technical issue related to internal medicine, which is very serious. Furthermore, endoscopic treatment is far safer than surgical treatment. The most terrifying complication of endoscopic treatment should be massive bleeding or perforation. However, the patient's symptoms and signs do not support the occurrence of these two serious complications.

  Xie Wanying said: "It's a pulmonary embolism."

   Fang Xueqing and Doctor Ma stared at her for a while, then looked at each other. They, as gastroenterologists, had never heard of this complication.

   "Some papers have reported such cases." Xie Wanying told them.

   "Professor Fang?" When Doctor Ma asked Professor Fang, he was completely undecided. Pulmonary embolism is extremely rare in the clinical department of gastroenterology. He, a young man, had never seen it before, so he could only ask the professor if the patient's symptoms could be suspected of pulmonary embolism.

  Fang Xueqing frowned. To speak of pulmonary embolism, she seemed to have never seen it before. She is a gastroenterologist, not respiratory or cardiothoracic.

   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 used to infer clinically. It can only be used as a reminder that clinicians may need to pay attention to the existence of this special case.

  How to determine whether what Xie Wanying said was a guess made by random thoughts in a paper? Some medical students who like to do research and research papers out of the clinic are like this, and they immediately become suspicious when they see similar cases in the clinic. In the eyes of the clinical teacher, this kind of medical student is like deliberately showing off his talent and showing off his skills, which makes the clinical teacher not very fond of it.

   Guessing is fine, but it needs to be supported by evidence. 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 wasted. Once a medical dispute arises, the patient's family will attack the doctor with this. Now this patient, the patient's family members are already dissatisfied, and will they do random inspections to the patient? Fang Xueqing's brows were so wrinkled that she couldn't untie them. Doctor Ma was waiting for her decision, and sometimes looked down at the family members outside and was very anxious.

   "Doctor Song." Fang Xueqing asked Song Xuelin's opinion again.

  Song Xuelin said: "Do as Doctor Xie said."

   Fang Xueqing's eyes flashed with surprise: "Do you support her opinion, Doctor Song?"

  Doctor Ma was more anxious than anyone else, and asked anxiously, "If pulmonary embolism is suspected, what should I do? Should I send it for CT right away?"

   They are too rare in their subjects, and it is easy for doctors to suddenly forget the relatively remote knowledge points in the textbook.

"You can try a blood gas analysis first." Xie Wanying suggested, "This cost is not high, and the results are very fast. In the case of acute pulmonary embolism, the patient's body is hypoxic and suffocated. The typical performance of blood gas analysis is that blood carbon dioxide and blood oxygen are both high. Low. This kind of inspection report can be said to distinguish a lot of diseases, and it is an important reference indicator. After there is data support, other inspections will be considered for further confirmation. "

   (end of this chapter)


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