Li Qifeng performed a normal physical examination on Zhao Xiaohong with a stethoscope on the side. His body temperature was normal, his heart rate was normal, and his blood pressure was still good.

The blood pressure is still stable and the heart rate is unfast, which means the patient does not have significant heavy bleeding.

This is true when an emergency department doctor encounters any patient. First of all, he must rule out the most serious and fatal disease to be at ease.

Li Qifeng asked loudly while checking, "When will it start to hurt, and where will it be the main thing."

Zhao Xiaohong's whole face was full of painful face, and she looked a little unbearable with abdominal pain!

She pointed to her lower right abdomen, and tears were already spinning in her eyes!

"It hurts, it's been a day." Zhao Xiaohong covered his right lower abdomen with his hands.

Li Qifeng pressed along the way he put his hand, and the abdominal wall was indeed very nervous and a little hard to press!

Li Qifeng said: "Is it the most painful thing for the lower right abdomen?"

Zhao Xiaohong was speechless, and she bit her lip and nodded.

For right lower abdominal pain, acute appendicitis must be considered. This is a situation that ordinary clinicians will first consider. There are many organs in the right lower abdomen, but appendicitis is the most common!

Typical abdominal pain in appendicitis should start with pain around the navel. When the appendicitis reaches a certain level, the pain will gradually be fixed in the right lower abdomen. This is also a classic metastatic lower abdomen.

Because the pain positioning is not obvious during early appendicitis, and the distribution of nerves in the abdominal organs is crossed, not one organ has a specific nerve, so in the early stage of appendicitis, the brain will think that there is a problem with the navel, so it is impossible to determine where the pain is.

Only when appendicitis is severe enough, or even if appendicitis seeps out to the surface, these inflammatory fluids stimulate the peritoneum in the local area of ​​the appendix of the right lower abdomen, and the pain nerves in the peritoneum are transmitted to the brain, will the brain know exactly that the lesion is in the right lower abdomen, rather than the navel, and then the right lower abdomen will be very painful.

At this time, you need an abdominal ct!

"Didn't it start with pain around the navel?" Li Qifeng asked her.

It seems that he is really considering acute appendicitis. Zhou Yewu watched Li Qifeng's consultation, and then muttered in his heart.

After a while, Zhao Xiaohong said with difficulty: "It has always been a pain in the lower right abdomen."

Zhao Xiaohong's expression was already distorted in pain, and her originally beautiful face became a bit ferocious like an evil ghost.

When Li Qifeng heard her say that he did not have metastatic lower right abdomen pain, he was still a little hesitant, not knowing whether he should believe it, because too many patients often missed the condition, resulting in misdiagnosis!

"Would you feel nausea, vomiting, abdominal distension, etc." Li Qifeng continued to ask.

Zhao Xiaohong shook her head desperately.

"Have you ever had appendicitis before?" Li Qifeng was still a little unwilling to give up!

He was afraid of missing appendicitis...

Zhao Xiaohong still shook her head. She seemed to be still sober, so Li Qifeng did not continue to ask questions.

"I have had an abortion before." Zhao Xiaohong said with some difficulty.

She kept frowning, and it was obvious that the pain had not been relieved!

Zhou Yewu has been staring at the ECG monitoring, for fear that blood pressure will fall, and the pain may also cause shock!

Seeing this, Li Qifeng had to pull up the bed curtains around her and start checking her body.

He deliberately left a female nurse and Zhou Yewu by his side. When checking the female patient, female medical staff was needed to prevent conflicts. As the main treatment of the emergency department, Li Qifeng was also very clear about these details!

During this examination, my abdomen was obviously not nervous!

I don’t know if the abdominal wall tension was caused by psychological factors or the stool was not resolved, but now it is indeed soft!

"The abdomen is soft and there is no obvious tenderness." Li Qifeng said.

However, there is indeed tenderness in the right lower abdomen. When diagnosing appendicitis, you must distinguish it from kidney stones, gallstones, pancreatitis, intestinal obstruction and other diseases. Therefore, Zhou Yewu noticed that Li Qifeng also had a corresponding physical examination. The percussion pain in the liver and gallbladder area was negative, but the percussion pain in the right waist seemed to be positive.

When Li Qifeng tapped him gently, Zhao Xiaohong's condition was not good. The whole right waist gave Li Qifeng the feeling, which might be abdominal pain caused by kidney stones and ureteral stones?

Zhou Yewu kept observing Zhao Xiaohong's face carefully. Although he didn't check it, he could clearly know the changes in her expression as Li Qifeng pressed!

You should know that if a patient with kidney stones and kidney colic, if you hit his waist, it will cause severe pain!

Some of the atypical ones may just be pain, but not necessarily severe.

But no matter what, there must be a problem with the pain of waist penetration.

Knocking pain is a must-check method in physical examination. In the past, when there were not so many examination equipment, such physical examination was very, very necessary! Because it can quickly find problems. Before you can take them to check, people will clearly have kidney stones. But it must be admitted that such knocking pain is rough, inaccurate, and there will be errors. The examination that should be done is still necessary.

So Li Qifeng had to shake his head: "Pay the money and do some more inspection."

Zhao Xiaohong nodded, and the nurse pricked her with a few tubes of blood to be tested!

Originally, she was a person who was afraid of pain, but the pain of these needles was nothing in the face of abdominal pain!

After the result comes out!

There is no obvious abnormality in blood routine, and the urine hcg is negative.

She asked Li Qifeng why he wanted to keep urine.

Li Qifeng smiled at the corner of his mouth: "There are two considerations for keeping urine. One is to test whether you are pregnant. The other is to test whether there is a urinary tract infection and see if there are white blood cells, red blood cells, etc. in the urine."

She didn't seem to understand very much, especially when she heard about whether she was pregnant or not, she hesitated for a moment, but in the end she paid for the test.

The result of urine hcg was negative, indicating that he was not pregnant. This made Li Qifeng feel relieved. At least he didn't need to ask a gynecologist to come for consultation. The urine pregnancy test uses laboratory methods to test the level of human chorionic gonadotropin hcg in women's urine. During pregnancy, this hormone will increase and early pregnancy can be detected.

The results of B-ultrasound in the abdomen also came out. There was water accumulation in the right kidney, the upper part of the right ureter was dilated, and there was no obvious abnormality in the gynecological B-ultrasound, and there was no appendicular abnormality in the right lower abdomen appendix area.

After seeing this result, Li Qifeng secretly thanked that he was indeed right. It was indeed a urinary tract problem. It was not obvious that it was a problem of hydronephrosis.

But what puzzled him a little was that there were no obvious red blood cells or white blood cells in urine routine.

Generally speaking, if there are kidney stones and the stones cause infection, then there are red blood cells and white blood cells in the urine routine.

"Do you have any ideas?" Li Qifeng suddenly looked at Zhou Yewu with a smile while thinking.

You have no idea about the subject, what can I think of? He rolled his eyes.
Chapter completed!