The chief resident of the Department of Hepatobiliary and Pancreatic Surgery rushed down for consultation and was dumbfounded after reading the scans.
The patient's upper abdomen was in obvious pain, and he kept rolling on the stretcher trolley. But the more he moved, the more painful it was. The more painful it was, the more he couldn't calm down.
"I'll look for a second-string surgeon," Chief Resident Zhou Litao said. "I reckon we'll have to perform an emergency surgery."
That was what Zhou Litao thought as well. The patient's biliary tract was blocked, and there was severe pain in the upper abdomen. Emergency exploratory laparotomy was necessary. He estimated that conservative treatment would not be effective, and he did not dare to casually give analgesics, for fear that complications such as perforation would not be discovered.
Looking at the patient rolling on the stretcher trolley, Zhou Litao felt the pain. It was a lot of suffering.
"Okay, I'll find someone to send the patient to the ward area with you," Zhou Litao said.
After that, he put the ultrasound report and the CT films of the upper abdomen into a bag and handed them to the chief resident of the hepatobiliary and pancreatic department. Both of them strode toward the resuscitation room and prepared to send the patient to the Department of Hepatobiliary and Pancreatic Surgery.
While they were waiting for the results of the emergency laboratory tests, the nurses in the Emergency Department had already inserted a gastric tube and urinary catheter for the patient and placed an intravenous passage. If he was preparing for surgery, he just needed to go back and prepare the skin. The efficiency of the Emergency Department was always so high.
When he arrived at the emergency resuscitation room, the patient was retching.
Zhou Litao had briefly inquired about his medical history before, but because the situation was too urgent, he didn't ask for too much detail.
The patient was a 24-year-old university graduate. He had just returned home from school and was looking for a job. But he didn't expect to suddenly have a stomachache at night. His family didn't know the specifics of the situation.
Retch … retch … The patient was retching. Because the vomiting was too intense, his stomach and intestines were already empty, and he could only vomit out some acid.
She did not vomit blood, and there was no food in her vomit. Even after the gastrointestinal decompression, the vomiting still did not improve.
The nurse was helping her tilt her head to prevent vomit from causing accidental aspiration, which could lead to more serious complications.
"Send the liver and gall bladder!" Zhou Litao shouted and began to help push the stretcher trolley out.
When the stretcher trolley moved, it seemed to involve the gastrointestinal tract. The girl poked her head out from the stretcher trolley and almost bumped into the emergency resuscitation room door.
Zhou Litao hurriedly stopped the stretcher trolley, feeling a lingering fear in his heart.
If he bumped into something and caused a head injury, it would be an iatrogenic injury. That would be f * cked.
"Ugh …" Before Zhou Litao could finish his thought, the girl began to vomit even more violently.
At this moment, she did not even have any gastric juice left. Tears flowed from her eyes as she continuously retched violently.
What kind of illness was this? It did not look like a calculus. Zhou Litao was still pondering over the radiographic films while instructing the patient's family to take good care of the patient and not cause any external injuries.
However, the patient gripped the stretcher trolley's guardrail tightly. Her body was spasming, and she vomited violently. No matter how her family tried to persuade her, her head was still outside.
Zhou Litao was just about to ask someone to protect him so that he could send the patient to the Department of Hepatobiliary and Pancreatic Surgery as soon as possible. Before he could say anything, the chief resident of the Department of Hepatobiliary and Pancreatic Surgery suddenly shouted, "Hold on!"
"President Chen, what's wrong?" Zhou Litao asked in surprise.
Chief Chen strode to the gastrointestinal decompression table and picked up the negative pressure bottle.
Zhou Litao focused his gaze and was immediately stunned.
A worm was sucked out by the negative pressure. Half of its body was in the pipe, and the other half was struggling in the negative pressure bottle.
Holy shit … what the hell is this?!
Zhou Litao was experienced and knowledgeable, but he had never seen worms in gastrointestinal decompression.
Chief Chen's face turned green. He was still holding the phone in his hand, communicating with the second-tier Professor Yang. At this moment, he immediately said, "I saw a worm in the patient's gastrointestinal decompression. It's white, about six centimeters!"
"Ugh …" The patient vomited violently and finally vomited something out.
It was another yellow-white worm!
However, there was no gastric juice. The worm was not vomited out, but hung at the corner of the patient's mouth. It was as if there were countless worms in her body that were crawling out …
"Professor Yang, there's also a worm in her mouth …" Chief Chen was also a little confused. "It looks like a roundworm. It's yellow-white and earthworm-shaped."
"Okay, I'll make preoperative preparations immediately!"
After saying that, he hung up the phone.
"Send them away, send them away!" Chief Chen shouted anxiously. "Go to the Department of Hepatobiliary and Pancreatic Surgery and prepare for emergency surgery!"
As he watched the group of people leave and disappear around the corner, Zhou Litao still saw the image of the gastrointestinal decompression and the squirming worm that appeared in the innermost part of the gastrointestinal decompression table.
If it was a roundworm … Human roundworm disease was a common parasitic disease caused by roundworms parasitizing the human small intestine. The incidence of it was relatively high in children.
The adult roundworm was cylindrical, like an earthworm. The eggs were oval, and the surface of the eggshell was often covered with a rough and uneven protein membrane. It was brownish-yellow due to bile staining.
Children were more likely to have roundworms, but adults were less common.
However, how could an adult have so many worms constantly 'coming out'? Zhou Litao was a little confused.
"Chief Zhou, what is that thing?" a young nurse asked as she cleaned the emergency resuscitation room.
"It looks like a roundworm to me."
"Don't roundworms come out of the feces? Why does it flow back out of the mouth?" the young nurse asked.
Zhou Litao shrugged. He did not know what was going on.
Generally speaking, roundworms should not be very heavy. It would be fine to take some insecticide. Legend had it that people who grinded their teeth had roundworms. A few pieces of intestinal worm serum would be fine.
This thing was not like the pig head tapeworm. It was rare to see fatal ones. It was just disgusting. Who would not be afraid to see worms in feces?
"When I was shopping online a few days ago, I saw someone selling roundworm egg capsules. They said it was for weight loss. They added money and insecticide," the young nurse said with lingering fear. "At that time, I was thinking about buying some to eat during my annual leave."
"Why do you dare to eat anything? That thing is so disgusting," Zhou Litao reprimanded with a straight face.
"Chief Zhou, if you don't find a girlfriend, you won't know …"
With one sentence, Zhou Litao's scarred heart was ruthlessly stabbed again. He did not hear what the young nurse said after that.
"Why do you have to wait for the holidays?" Zhou Litao asked absentmindedly.
"It is said that one week after eating roundworm egg capsules, there will be a low fever and discomfort all over the body. Some people will also have nausea and vomiting. Look at her vomiting too much! It's a little scary. I'd better think of other ways. "The young nurse quickly cleaned the emergency resuscitation room and turned on the ultraviolet light to start disinfecting.
Zhou Litao thought for a moment, picked up his phone, and called Chief Chen of the Department of Hepatobiliary and Pancreatic Surgery.
What the young nurse in the emergency department said just now was an important clue. Otherwise, there was no way to explain the roundworms' coming out 'from the innermost part.
After hanging up the phone, Zhou Litao began to look at the patient's upper abdomen CT on the computer.
If the roundworms had burrowed into the bile duct, imaging still supported it. However, adult biliary ascariasis was very rare. Zhou Litao studied it bit by bit to enrich his clinical experience.
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