Chapter 1311: Bleeding Again

Chapter 1311: Chapter 1311: Bleeding Again

Liu Banxia can be considered a seasoned frontline warrior, but encountering a patient with such a large volume of bleeding where the bleeding point cannot be determined is a first for him.

But where exactly is the patient’s true bleeding location?

If even this cannot be determined, don’t even talk about any tests, stopping the bleeding successfully is impossible.

Just now with such a large amount of bleeding, if it is not controlled, recrudescing two or three more times, the patient might truly not even have a chance of resuscitation.

"Doctor, what kind of examination should be done next?" the patient’s wife asked.

"Based on his symptoms, gastrointestinal bleeding is undoubtedly occurring," Liu Banxia said.

"But the gastroscopy and colonoscopy we performed were negative, so it’s possible he has a bleeding point in his small intestine. However, our current endoscopy cannot reach the small intestine to allow us to see clearly."

"So, my suggestion is to take him to the catheter room for angiography, which is an interventional therapy. Contrast dye is injected into his blood vessels, and if there is a bleeding point in the small intestine, we can see it clearly."

"But this examination is also invasive. We will first conduct an allergy test to see if there will be an allergic reaction to the contrast dye. Then we can perform an abdominal CT to get a general understanding."

"But from the current situation, I personally lean toward a bleeding point in the small intestine, which is the only area left unchecked for now."

"Xu Yino, explain the situation regarding interventional examination to them. I will also contemplate further to see if there are any other solutions."

Xu Yino nodded and hastily explained the possible situations that might occur during interventional examination.

If it’s merely simple non-invasive tests, those are fine. The patient and his wife were considering them just now. But upon hearing that contrast dye could potentially harm the kidneys, the couple hesitated.

"Doctor, are you saying that my bleeding situation may just stop spontaneously?" the patient asked after slight hesitation.

"It could, but only temporarily. It might recur with emotional agitation or positional changes," Liu Banxia replied.

"You have seen your bleeding situation; it’s such a large volume, definitely not as simple as a capillary rupture. Although interventional examinations carry certain risks, considering the current circumstances, it is most suitable for you."

"Doctor, are there no other examination methods? Can’t CT or MRI work?" the patient’s wife asked.

"Without intervention, it’s just getting a general look. It’s mainly used to observe bone or organ conditions. For similar vascular bleeding, the chance of capturing it is too low," Liu Banxia said with a frown.

"How about we do an abdominal CT scan first and see the situation? If it doesn’t show anything, we can discuss the interventional examination later."

"His bleeding volume is really too large. Just now, he lost so much blood that we are stabilizing his blood pressure with transfusion and fluid replenishment."

"Then let’s do the CT first, a simple scan. The contrast dye risks are too great; I don’t want my kidney damaged before the bleeding issue is found."

Xu Yino looked at Liu Banxia, and Liu Banxia nodded.

Slightly helpless but respecting the patient’s choice.

Unlike when the patient arrived without consciousness, now not only is he conscious, but he is also expressing his opinion very clearly, so interventional examination must be postponed.

Although knowing the bleeding point is crucial right now, it does not mean an abdominal CT scan is entirely futile.

The patient’s current situation is still peculiar; such large bleeding volume, if self-vascular constriction were to heal temporarily, stopping the bleeding, the difficulty level is somewhat high.

Arriving at the CT room, seeing Liu Banxia personally coming over, Wu Bo was startled.

"This patient’s situation is rather urgent, the bleeding volume is large, and both colonoscopy and gastroscopy are negative, let’s scan the abdomen first for a look," Liu Banxia said.

"Contrast dye is convenient, plain scan hardly detects anything," Wu Bo said.

"Sigh...the patient has concerns about the contrast dye, let’s scan first," Liu Banxia said.

"There’s no choice; if we don’t explain clearly, it’s our responsibility when issues arise. Explaining it, our details are quite alarming, intimidating anyone listening."

"In that case, you could at least go with laparoscopy. Make an incision on the small intestine, put in an endoscope, and directly address any problems found," Wu Bo suggested.

"There’s a large blood stain on his pants, almost as much as postpartum hemorrhage’s volume. Not having gone into hemorrhagic shock directly is quite fortunate."

"Fortunately, the emergency response was immediate, rapid fluid expansion had begun upon arrival," Liu Banxia said.

"We’ve opened another venous channel here, swiftly replenishing blood and fluids, but I’m worried the next bleed might not be minor."

"I’m pondering now how to find the bleeding point. Without finding it, everything else is moot. Anyway, make sure to take a good look, his current stable appearance is actually quite dangerous."

Wu Bo nodded.

If we want a thorough examination, we’ll need to look at the entire abdominal cavity, which will take extra time.

"You’ve already looked at the intestines and stomach, so let’s focus on the other organs," Wu Bo said.

"I’m counting on you. If we can identify the issue, it’ll be perfect," Liu Banxia said.

Wu Bo grinned, but he had no confidence whatsoever.

If you want to scan for a tumor or check for calcification on the organ surface, that’s doable. Finding bleeding? Unless there’s hematoma, it’s futile.

"Director Liu, everything seems fine. The kidneys have stones, but that’s normal. There’s a small stone in the pancreatic duct, but it appears stable," Wu Bo said after the scan results came out.

"There’s nothing apparent in the small intestine on the CT. Check other places, though, because it feels like we haven’t found anything,"

Liu Banxia stared at the screen for a long time, suspicious only of the stone in the pancreatic duct.

If this stone had any specific "role," the patient should exhibit symptoms of pancreatitis like abdominal pain or weight loss.

But after consulting the patient, it turned out that he had no discomfort.

"Doctor Wu, do you think this small stone is causing trouble?" Liu Banxia asked.

"I can’t be sure. Even if you ask me, I’ll leave it to you to decide," Wu Bo said.

Liu Banxia nodded, "I’ll have others look at the films with me. It’s really hard to judge right now. Since it’s the pancreatic duct, if there’s no problem with the stone, doing surgery would be too invasive."

"So, this decision rests with you. My expertise isn’t sufficient," Wu Bo said candidly.

It’s no joke. Any pancreatic surgery must be approached with caution.

If an error happens leading to a pancreatic fistula, the situation will become serious.

If the condition resulted from this stone, trying is reasonable. But without certainty, who would dare to cut open the pancreatic duct to investigate?

"Doctor, was there any result?"

After Liu Banxia came out, the patient’s wife asked nervously.

"CT scan didn’t show much, except a small stone in the pancreatic duct. It’s hard to determine if it’s causing the bleeding," Liu Banxia said.

"Think back if you’ve experienced abdominal pain or back pain? Or do you frequently have diarrhea?"

"No pain, but sometimes diarrhea after eating cold or spicy food, but that’s normal, isn’t it?" the patient responded.

Liu Banxia felt stumped, as this kind of diarrhea is aligned with normal digestive responses. Not everyone’s stomach can easily handle spicy or cold food, so it’s normal.

"Personally, I suggest doing an angiography. Though there’s a possibility the stone caused symptoms, you lack other signs," Liu Banxia said after considering.

"Can we discuss it further?" the patient asked.

"Alright, but try to decide soon. Although the interventional check carries some risk, it’s less invasive than an abdominal exploration," Liu Banxia said.

"Your bleeding is severe; we can’t ignore this. If we don’t find the bleeding point, it could lead to more serious bleeding."

The patient and his wife nodded, understanding Liu Banxia’s rationale, as it was considering their best interests despite their concerns about contrast agents.

"Teacher Liu, what should we do if they refuse the angiography?" Xu Yino asked.

"Just wait. If they don’t agree, we’ll monitor in the hospital until bleeding occurs, then proceed with the intervention," Liu Banxia replied.

"Since it’s an invasive test, we can’t insist. But not testing is also a concern. The situation is really complex now."

"Teacher Liu, the patient’s bleeding again."

At that moment, Su Wenhao called out.

Liu Banxia quickly looked over to see the patient’s hospital pants soaked.

"Keep waiting? We need to do the angiography," Liu Banxia said to the patient.

"Yes, yes, I’m feeling dizzy," the patient replied shakily.