At 11:00 noon, and as I got off work, a mother and son came to Dr. Song’s clinic. At this time, the clinic was still bustling with many patients.
Abdominal pain
"What's wrong?" Dr. Song asked kindly and kindly.
"Stomach hurts, vomiting and ejaculation!" The mother said to the doctor after looking at the boy.
"How long has it been?" Dr. Song began to typing the medical records on the computer.
"When I wake up in the morning, it's about seven o'clock." The man continued to answer.
Doctor Song took a look at the clock hanging on the wall, and then wrote the medical record: "That's 4 hours." It is very important to ask about the onset time when asking about the medical history, which is helpful for the doctor to judge the course of the disease.
Then, the doctor asked the boy how the pain was. The boy said that it was mainly in the left middle and lower abdomen, with paroxysmal colic, vomiting multiple times during the period, which was also accompanied by diarrhea, and the stool was mushy, and there were no special discomforts in the others.
Dr. Song learned about this and began to take the boy's temperature, blood pressure, and auscultize the heart and lungs, but no abnormalities were found. Then the boy was lying on the examination bed. The examination found that was soft and there was a slight tenderness under the xiphoid process in the upper abdomen, and a slight tenderness in the right middle abdomen and the lower abdomen on the right, without rebounding pain. The right Mai's dot has no tenderness. There is no percussion pain in the right renal area, and no percussion pain in the left renal area. intestinal rumbling is normal. No swollen lymph nodes were touched in the right groin.
Boy abdominal pain is a difficult point for doctors. Abdominal pain itself is a difficult point in clinical emergency, because there are too many causes of abdominal pain. Life-threatening ones include myocardial infarction, aortic dissection , pulmonary embolism , etc., while abdominal diseases include intestinal obstruction, gastrointestinal perforation, appendicitis , pancreatitis , etc. These all require doctors to eliminate through experience, and of course, they must use the help of examination.
B ultrasound examination
So, the doctor asked the boy to check for blood routine , urinary color ultrasound, and appendix area B ultrasound .
Since it is an emergency room, the examination results came out quickly. Dr. Song clicked on the computer and looked at the examination results and found that the blood signs were elevated, the color ultrasound of the urinary tract was not abnormal, and the B-ultrasound in the appendix area was severely disturbed due to a large amount of qi accumulation in the intestines, and the appendix was unclear.
Seeing these test results, Dr. Song also had a basic diagnosis in his mind: The causes of abdominal pain, vomiting, and diarrhea: acute gastroenteritis? Acute appendicitis ?
The cause is not clear yet, so you can only give antiemetic, acid suppression and stomach protection, antispasmodic and pain relief treatment first.
originally thought that this patient would end like this. Who would have thought that at around 2:45 pm, after the infusion was completed, the boy and his mother found Dr. Song again, saying that the patient's condition after the infusion was much better.
At the same time, "There are many people in the morning, and my son is embarrassed to tell you. In fact, he has more than just a stomachache!"
Doctor Song immediately became serious and asked quickly, "What else is there to feel uncomfortable?"
At this time, the boy showed an embarrassing expression on his face. His mother explained, "There are many people in the morning, and he has no nerve to say that his scrotum hurts even when he wakes up!"
Short color ultrasound
When Dr. Song heard that, without saying a word, let the patient lie on the examination bed, took off his pants and started the examination, and found that the perineum of was developing normally. The scrotum is enlarged and the skin on the surface is red. The right testicle on the palpation is larger than the left side, and the tenderness is obvious. There is pain when the scrotum is lifted and supported, accompanied by palpation action. The lymph nodes and lumps were not touched on both sides of the inguinal cavity.
At this time, the boy said, "After the infusion, the situation is much better than in the morning." After the examination of
, Dr. Song said seriously, "This is the hospital, there is nothing to be embarrassed about. If you don't say it earlier, delaying the treatment time, the consequences will be very serious. Now it is suspected that it is acute testicular torsion, and a color ultrasound examination is needed."
acute testicular torsion, also known as sperm cord torsion, is due to the long mesangial mesangial, which is easy to cause testicular and sperm cord torsion, which is often caused by the disease during sleep, which is prone to occur in adolescents and children.Acute testicular torsion begins, and the pain is limited to the scrotum, which can develop to the lower abdomen or perineum in the later stage, and will also be accompanied by nausea, vomiting, diarrhea, etc.
Soon, after the patient had a B-ultrasound, he determined that the testicle torsion was caused and urgently admitted the surgery. After seeing it, the surgeon said that he needed surgery as soon as possible.
Explain the condition
Because the patient complained about abdominal pain, diarrhea and vomiting when he was in the treatment, he did not mention the history of scrotal pain at all. Generally speaking, doctors will not deliberately check the patient's privacy during physical examination, which causes missed diagnosis. Therefore, when visiting the doctor, patients do not have to be embarrassed. They should tell the doctor truthfully about all diseases-related situations in the hospital, so that they can help doctors better treat diseases.
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