"Miss Wu, take a look and see if it''s this," Han Quinn said.


    "Look at the film." Wu Mian smiled.


    Han Quinn opened the reader and hit his shoulder. Yang Lei staggered and was directly knocked away.


    When the film was inserted into the reader, Yang Lei and Wei Dabao didn''t understand it for a long time.


    "Here it is," said Wu Mian, lighting the film. "There is a small amount of hematoma in the rectus abdominis sheath."


    "Sure enough." Han Quinn said with emotion after confirming, "Miss Wu, this case reminds me of the previous two special strange appendicitis."


    "The physical signs were very clear. When I opened it to see the appendix, there was no swelling. I said there was no inflammation, but I thought it must be appendicitis. I said there was inflammation, but it wasn''t like it," Han Quinn recalled.


    "You opened the knife at the normal Michaelis point, not at the tender part, right?"


    "Yes." Han Quinn nodded.


    "It may be caused by rectus sheath hematoma," Wu Mian said with a smile. "This is a rare disease, but it is particularly easy to be misdiagnosed."


    "Miss Wu, is it a muscle tear?"


    "The rupture of the superior abdominal artery, inferior abdominal artery or their branches in the rectus sheath, or the direct tear and bleeding of the rectus abdominis, its clinical manifestations are very similar to some acute abdomen, and it is easy to be misdiagnosed as abdominal and pelvic diseases and blind surgery. Therefore, correct diagnosis and treatment are particularly important," Wu Mian said.


    "Sit ups, I remember." Han Quinn was honest at the moment. He didn''t care about the problem of face. He was immersed in the rectus sheath hematoma.


    "That''s not certain." Wu Mian said, "the last patient I treated with rectus sheath hematoma was Datong... Cough."


    "What''s the big deal?" Han Quinn asked subconsciously.


    "He is an American celebrity." Wu Mian said, "I found abdominal pain after playing golf. I happened to be nearby, so I went to see him. Finally, I did CT and was diagnosed as rectus sheath hematoma."


    "Local blunt contusion of abdominal wall, iatrogenic injury, severe cough, severe vomiting, sneezing, excessive defecation, sit ups, standing long jump, golf and other sports can cause excessive contraction of abdominal muscle and uncoordinated movement, resulting in rectus abdominis sheath hematoma."


    "To say more, hypertension, atherosclerosis, pregnancy and childbirth are also common risk factors." Wu Mian said, "especially childbirth is a common inducing factor." Wu Mian explained flatly.


    A rare case almost broke his fingers and said one, two, three, four, five, which made Han Quinn ashamed. It doesn''t seem very rare to hear Mr. Wu say so.


    "I remember." Han Quinn nodded repeatedly. These things are difficult for ordinary people to memorize. But for an old doctor with many years of clinical experience, it''s nothing at all.


    Don''t recite, just understand.


    "Mr. Wu, since it''s a hematoma, do you think B-ultrasound can''t do it? I think B-ultrasound can also make a clear diagnosis." Han Quinn asked, "and B-ultrasound can also take a look at the pelvis and accessories, killing two birds with one stone."


    Wu Mian smiled with satisfaction, "director Han, your level is good."


    "Ah?" Han Quinn was stunned.


    "People with a slightly lower level will not think of this problem." Wu Mian said, "ultrasound is an important auxiliary means for the diagnosis of rectus sheath hematoma. It can be used as screening, post-treatment reexamination and pregnant women''s examination. Its diagnostic sensitivity is high, but some cases lack diagnostic specificity and are easy to be confused with separated cystic masses. The overall diagnostic accuracy is 70% ~ 90%."


    "Conventional plain CT scan can well show the location and scope of hematoma and its relationship with surrounding tissues. It is the first choice for the diagnosis of rectus sheath hematoma. The diagnostic accuracy and specificity are 100%, and can further classify hematoma, guide clinical treatment and judge prognosis."


    "Oh, so it is," Han Quinn said thoughtfully after comparing the images of the two auxiliary examinations.


    "The CT findings of rectus sheath hematoma may be different with the extension of onset time.


    The acute hematoma shows high density, then gradually turns to mixed density, and finally absorbs and liquefies to show low density. Therefore, when the CT plain scan performance is not typical, we should pay attention to distinguish it from the tumor lesions of rectus abdominis, and further enhanced scanning is helpful to make a clear diagnosis. The focus is also to inquire about the medical history, such as... "


    Wu Mian talked endlessly. It was just a CT film of rectus abdominis sheath hematoma. He told Han Quinn for half an hour.


    When he heard the dew, he thought he could do it, but he didn''t expect that chief Wu could talk so much about a "small" problem alone.


    "MRI is helpful to distinguish rectus sheath hematoma and other anterior abdominal wall tumors. It is often used to diagnose patients with atypical CT signs and contraindications to enhanced CT scanning. Most patients with rectus sheath hematoma can be completely absorbed after conservative treatment, and the prognosis is good." Wu Mian finally finished his speech, he said with a smile, "Tell the rest to the patients. I think they believe you."


    "Good, good, good." Han Quinn said three good words in a row.


    "Then I''ll go home." Wu Mian said, "director Han, I''ll see you again when I have a chance."


    Looking at Wu Mian''s stride away, Han Quinn hesitated for a moment, then ran over. His waist was bent and he was holding a mobile phone. "Miss Wu, can I have the honor to leave you a contact information?"


    "OK, don''t be so polite." Wu Mian smiled and then said his mobile phone number.


    "I''ll add my wechat friend later and mark director Han."


    "Please."


    Han Quinn watched Wu Mian leave. He didn''t straighten up until his figure disappeared for 20 seconds.


    "Director Han." at this time, the patient''s family dared to gather together and asked in a low voice.


    Han Quinn explained the rectus sheath hematoma to him again, and taught him how to go home for conservative treatment and how to do hot compress. He said everything in great detail.


    Although Wu Mian has left, Han Quinn seems to treat in front of Wu Mian and dare not make any mistakes.


    After handling everything, Han Quinn called a car and left bajingzi traditional Chinese medicine hospital.


    Mr. Wu is really young, but his level is really high, Han Quinn thought.


    High level, and no shelf. At the beginning, his tone seemed to be a little blunt, but Mr. Wu didn''t take it seriously. He explained rectus abdominis sheath hematoma to himself in warm words.


    Han Quinn didn''t go to dinner, but went straight home. Along the way, he was feeling that Mr. Wu was really a person with no shelf and ability.


    Without a word overnight, Han Quinn got up early the next morning for ward rounds. He asked for the test sheet of the patient for surgery again. He went to pick up the plane at noon to prepare the professor for surgery.