Men's stomach pain, sudden death during the infusion!Does the medical accident still have another hidden love?After the professional doctor, I doubt after another ...

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Men's stomach pain, sudden death during the infusion!Does the medical accident still have another hidden love?After the professional doctor, I doubt after another ...

2022-01-25 00:07:18 47 ℃

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No one will think, later he is in this hospital.

28-year-old male patient, she didn't have time.

My girlfriend saw him in the rescue room, and the electrocardiogram turned into a straight line. I saw his eyes became gray. The body limbs became a miserable color. He opened his mouth, his eyes were very unwilling.

He is a stomach pain in the hospital, how can you die? (Don't spray the hospital first, patient look)

A robust boyfriend suddenly died, which was too cruel for his girlfriend.

The girlfriend is poor, 4 years ago, my father died, 2 years ago, I died, only left with my mother. One year ago, he appeared, soon they identified men and women, he was very good for my girlfriend, very careful, and no more care.

She has also been a major illness.

In April 2021, she was hospitalized by the stomach bleeding. At that time, there were too many blood flow. Seeing that it is black (black, brain ischemic manifestation), almost planting the underground, squatting, doctors said this It is the brain ischemia caused by excessive bleeding. After the cerebral ischemia, the limbs are definitely weak, so the station will not be stable, and the blood flow is broken. If the rescue is not in time, you can't stop blood in time, or even happened Blood tract shock, or even died.

Fortunately, she was sent to the hospital in time. The doctor said that she had to be a gastroscope, and her boyfriend was afraid of gastroscopy, and he went directly to make a anesthesia (painless) gastroscope.

After the girlfriend finished the gastroscope, the person was still not awake, the tongue is still outside, and he is accompanied by his whole journey and takes the girlfriend's cute and funny small video.

He is a particularly strong person, the appetite is very good, there is no one in the meal, often helping the girlfriend to eat the leftovers, eat well. The body is particularly good, there has never been a history of heart disease.

But after 2 years ago, I have a pancreatitis and live half a moon. In addition, there is no other disease.

So everyone didn't think that a stomach hurt made him suddenly.

In fact, he has been sick for a long time, but everyone is not intended.

4 months ago, he suddenly disgused, and he began to vomiting (eating two bowls of porridge full vomiting), diarrhea, snoring, sweating, suspect is cold, think is a gastric cold.

Because he has been very good, he didn't go to the hospital to check, just bought medicine in the pharmacy, and then recovered after 2 days, you can go to work.

2 months ago, he began to appear stomachache after dinner, thinking that the window playing the game is cold, no way to go to work, please leave. Still don't go to the hospital, I bought medication. About one week, the stomach is not hurt, it is good.

2 days ago, they went to visit to eat, welcome New Year's Day, after eating, he started uncomfortable, stomach distress, because it has been an esophageal and stomach, think is the gastroesophageal return, ready to go to the pharmacy During the treatment of esophagus reflux, he kept cold sweat, and later, slowly driving home.

After returning home, it is hard to be reduced, thinking is indigestion. But feeling people are still a little virtual, even people are a bit confused. The stomach is not hurt, but it feels that it is burnned (seeing from symptoms, in line with the manifestation of digestive ulcer, gastric food return).

I spit it, I spit it out of the things you eat at noon, and the food is not digested and absorbed.

I thought this was ok, I thought it would pass.

The next day, she received WeChat, saying that the boyfriend went to the hospital and was injection.

He said that I would like to be a gastroscope, but the New Year's Day is resting, and I can't do gastroscopy.

My girlfriend is particularly panicked. I ask for calling to see him. It is his mother's call. I said that the hanging needle is finished, I will go home, I don't have to read.

There is no problem with the color ultrasound of the hepatobiliary pancreatic spleen before the injection, and pancreatitis is excluded. Only heart color is ultimate.

He has been comforting her, nothing, don't have to come with him.

Unexpectedly, this is actually their last conversation.

Shortly after the phone was put down, I received a call from his mother, let her come to the hospital. When she was hot, her doctor said that she has been rescued for half an hour.

The collapse, she doesn't know what to do, the brain is blank.

She has been holding the hands of the boyfriend, not willing to let go, and say it to the doctor on the ground. "I beg you, I first squatted to seek one person, I beg you, we will get married soon, you Press (press outside the chest). "

The doctor agreed, but the miracle did not appear.

She doesn't believe this is true, it is impossible, what is this?

The boyfriend's eyes are gray, the pupil should be scattered, there is still a temperature, the stomach is floating because the ventilator is still floating, the feet have been pale.

The girlfriend begged the doctor's electric shock, and his father didn't shock when he left. She has been regretted now.

At her insisted, the doctor made the final effort.

At this time, she stared at the equipment of the electric shock, and the doctors were turned on this machine. The doctor turned the electrocardi machine, opened, and the electric shock twice, the doctor gave up.

Everyone gave up.

Boyfriend said with his head, said over and over again, "Child, let Dad die for you, children, let Dad die for you."

Until today, my girlfriend couldn't believe that such a good one was so good, and she was quited in order to get married. Why suddenly didn't.

The doctor let the dress, otherwise it will not be able to do it later. His mother collapsed, not wearing, can't let your son don't know, to do corpse anatomy. Parents are not willing, girlfriends are not willing, and patients are not willing.

The doctor said that his heart has a hemangioma (the patient's family's original words), blood vessels were broken, so people can't do it. Everyone doesn't believe that the heart color ultrasound has not been done, how can he know how hemangioma?

After 3 days, the autopsy was finished.

Part of the specimen is transported to the field and needs 45 working days to produce results.

The mother said that when he first started, he was a stomach pain. The hospital gave an Amoxicin needle without the gastric bleeding. It also gave an Amoxicin needle. Mom, I am confused, I am uncomfortable, then people are gone.

If it is really a medical accident, they will not forgive this hospital.

Some people think that boyfriends may not be inspected and have failed to find problems in time. But his unit's welfare is very good, there are two medical examinations every year.

Now the result of the corpse is not yet, what is the cause of the patient? Everyone is working hard to pursue this answer.

The first is to invite the family. I analyze several patients with sudden death:

First, severe drug allergies. The patient used Amoxicillin, Mozidine, and Amoxicillin belong to penicillin antibiotics, and there were many people who allergically, so they generally do skin test before medication. And it will also ask the patient's past medication, there is no allergy.

But even if the patient has no allergies, even this time to do skin test is also negative, and it is not allowed to eliminate the patient. This medicine does not have allergies. Therefore, it is necessary to closely observe after using the drug, which is to prevent seriousness. Allergic reactions. The incidence of non-lethal penicillin allergic reactions is about 0.7% -10% (data of union emergency medicine), and the probability of death allergic reactions is very low, probably 0.002% or once every 7.5 million injections ( Commercial data of union emergency medicine).

If it is really a drug allergy, it is generally exposed to allergens, and there will be symptoms, in other words, if it is allergic, the needle water will quickly hang up will have reactions, generally in 30 minutes. Within, there are also symptoms that have been delayed to 1 hour.

If it is really a drug allergy, it is generally the most beginning to have a skin erythema and itching, and a general emergency doctor can identify. Then, due to the occurrence of allergic shock, dizziness, loss of consciousness, if the rescue is not in time, you can die in a few minutes.

The most critical to rescue allergic shock is to shut down the sensitivity (withdrawal of the original needle water, replacing the new physiological saline or other needle water to quickly supplement the liquid), and immediately use the adrenaline injection skin injection or muscle injection. Adrenaline is the most powerful anti-allergic, anti-anti-shock rescue drug, in addition to antimidemide drugs (such as Benzhamming), glucocorticoids can also be used.

In view, the patient is the possibility of lethal allergic reactions relatively small. Because the emergency department medication will ask the history of allergy, Amoxicillin, the probability of death allergies, even if there is allergy, because there is always a family member accompanying (patient mother), can also identify, And it can give drug rescue in time, usually not to die, also rescue it.

Second, the digestive tract is bleeding. Since there is stomachache before death (not necessarily stomach pain, you should be abdominal pain, may be the upper abdomen, because the patient is difficult to know that is stomach pain rather than the pain caused by the liver, pancreas, gallbladder diseases), There are also vomiting, return to the heart (burning panic), hair loss, swing, people confuse, etc. , Because there is no gastroscope, it is not possible to identify stomach bleeding in time, but also can't stop bleeding in time, although it uses Mo Mozidine (a drug inhibiting gastric acid), but there is no way to stop bleeding, patients may be in hanket (Intravenous infusion) When the digestion, the hemorrhage is exacerbated, and the blood loss shock occurs, so the blood pressure is lowered, and people are uncomfortable, coma, and even die.

But this possibility is not very big. There are several reasons for analysis. If it is really gastric ulcer bleeding, the patient's previous vomiting should be possible to vomit blood, but it is reflected in the food that is not digestible.

Secondly, if the emergency department has really happened a strong digestive tract bleeding, it is strong to fall into the blood pressure. It must be a lot of bleeding. Such a large amount of bleeding is likely to cause a vomiting, but no.

Finally, even if it is a severe bleeding, there is also a reaction process. After a lot of fast replenishment, it can be stabilized, and the time can be delayed, and it will not be rapidly killed. From the description of the family, the condition progresses quickly, and it is not a shock caused by the digestive tract.

Third, acute severe pancreatitis. Some people think that patients have had pancreatitis 2 years ago, the treatment for half a month, this time there is abdominal pain (patient is considered stomach pain), vomiting, does not rule out the possibility of pancreatitis again. This considers indeed existence. However, the patient's family said that when the emergency treatment, he did the liver and gallbladder, did not find problems, the pancreas did not have problems, they excluded pancreatitis.

Even pancreatitis, even the most severe severe pancreatitis, pancreatitis with high mortality, it is also a process, because the pancreas should be completely neat, inflammation is to spread to other organs (such as lungs, kidneys Wait, it takes a time, perhaps for a long time, a few days, etc., there will be a tricky cycle respiratory failure, rather than a few minutes, and the hour is developed to the never returned. Therefore, the possibility of severe pancreatitis is also small.

Fourth, the aortic dissection rupture. This possibility is the highest. It is also a consideration I support. Our detailed analysis.

28-year-old male, a high and strong, a few months ago, there have been digestive tract symptoms, including nausea, vomiting, abdominal pain, etc., but it is good forfending, this may be the manifestation of pancreatitis, It may be the performance of the gastric ulcer, or it may be the performance of the aortic dissection.

The most coarse artery of the human body is from the heart. This major artery walks all the way, gradually divides a lot of branches to nutrition brain, lung, limbs, liver, kidneys, pancreas, gastrointestinal tract, etc.

The artery is like a water pipe, it is possible to break, but the rupture is not a sudden, because the arteries have a few layers, the interior, middle, outer, and the outer layer is only the inner layer, the middle layer ruptures, the outer layer is still Complete, then the blood is rushing into the inner layer, the middle layer, like the above figure, the inner film has a broken mouth, the blood is rushed, then forming a false cavity, this counterfeit is called aortic dissection, very well understood .

This aortic dissection has two deadly points.

1. After the interlayer exists, it will seriously affect the blood supply of each branch, so the ischemic manifestation will occur all the way, if the upper arm blood vessels are affected, then the blood pressure of this side of the arm will fall, even It can't be fully measured because blood can't flow. If the kidney blood vessel is spread, kidney ischemia, renal failure; if the intestinal blood vessel is affected, intestinal ischemia, abdominal pain, nausea, vomiting will occur. If the spinal cord arteri is affected, it will cause the limbs to numb or even paralyzed. In short, there will be a variety of performance, what extent to which the sandwich is torn, which is the extent.

2. After the interlayer exists, everyone can also see that the artery is only wrapped in the last layer of the package. If you accidentally, this sandwich package will burst, this is the aortic dissection crack, so that blood pressure is rapid Spreading, 哗 全 全 全 头 腔 腔 腔 腔 腔 腔 腔 腔 不 不 腔 腔 腔 腔 腔 腔 腔 迅 腔 腔 腔 腔 腔 腔 腔 腔 腔 腔 腔 腔 腔 缺 缺The blood is not enough, and the organization is ischemia necrosis. The heart is not row, then death, this time is quite short, this bleeding speed and quantity are more than one thousand times more than the digestive tract bleeding ( There is an exaggeration, the purpose is to tell you that the sandwich rupture bleeding is extremely high-risk). Looking back to analyze the performance before the deceased, there is stomach pain (you think it is stomach pain, in fact, it should be abdominal pain or back pain), this pain is a typical manifestation of the aortic dissection, because blood vessels tear, there will be a very dramatic chest pain or back pain. Second patients have nausea and vomiting, which may be a blood supply in the sandwich torn, so there will be nausea and vomiting, not necessarily a stomach bleeding.

This aortic dissection can only be diagnosed by the abdominal CT enhancement scan, no way to discover the liver and gallbladder and colorfulness, so this color ultrasound diagnosis is basically unhealthy.

Patients may last for a few months, so it has repeatedly disgusting, vomiting, and abdominal pain, has not paid attention, no inspection, don't know. The condition is also progressive, not the beginning, it will be broken, otherwise it will not work.

This stomach pain (abdominal pain), go to the hospital, the venous infusion is not long, people can't, quickly shock, coma, then you should breathe, don't worry, the doctor is in a hurry to take the air tube cannula, the ventilator (family description) However, for patients with aortic dissection rupture bleeding, the ventilator, defibrillator is also futile, because the blood is always lost, the light has oxygen and the heart, no blood does not transport oxygen tools, body or Will have been hypoxia, then wait for death, and will be very fast, a few minutes.

Some people think weird, such a large number of aortic dissection rupture bleeding, why can't the appearance can't see? Yes. The aortic dissection is broken, and the blood flows into the chest or the abdominal cavity. It does not vomit the outside. It will not vomit, because the blood is not entering the gastrointestinal tract, but in the chest and abdomen cavity.

Therefore, I analyzed that patients should be the tragedy caused by the crack bleeding of the aortic dissection, and the patient's family mouth said that the doctor suspected that the cardiac aneurysm was being aneurysm. This so-called cardiac aneurysm is estimated to be a family person. It should be aortic dissection or aortic aneurysm. Wait, the heart color ultrasound has no way to find it unless the interlayer is tired and the aortic flap.

This is a very catastrophic emergency, is a nightmare of the emergency doctor, because this is a little bit of illness, and the age is 50-70 years old. If it is not pulling the chest and abdomen CT, there is no way to identify this disease.

The aortic dissection mortality rate is high, such as less than about 3% sudden death, the mortality rate in two days is about 50% or even higher, and 70% or even 90% in one week.

If the clinician is missed this disease, it is not a medical accident, I don't know. To avoid misdiagnosis of this disease, the most conservative approach is that every suspicion patient pulls out to make a chest and abdomen CT. How to rescue the aortic dissection rupture? Take a tricky, first is absolutely in bed, powerful calm sedation, if used in intervention or surgical treatment, the purpose is to prevent blood vessels to tear, steady blood vessels, do not let burst.

Of course, the aortic dissection rupture is just a guess, there is no evidence, everything is equal to the result of autopsy.

The dead is already awkward, I hope this young man will go all the way, I hope that the family will sorrow, I hope everyone can get some lessons from this case. When there is abdominal pain, if you vomit, you should not easily think that it is a stomach, and it may be a cardiovascular Diseases, some diseases have misdiagnosed, which may cause irreparable endings.

Note: The cases in this paper come from knowing.

Ai Lusha

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