Returning to ’90s, She Became Famous in Major Surgical Fields

   Chapter 2618 [2618] Broken blood

  Aortic aneurysm and aortic dissection are diseases that are difficult to detect clinically on weekdays, so it is too late for most patients to go to the hospital for treatment.

   Little Junior Sister is amazing. The most powerful thing about the younger sister is a tendon. Huang Zhilei sighed.

   When everyone was thinking about what to do with this pit, Xie Wanying was standing in front of the light board and had been studying the MR film.

   Duan Sanbao stood behind her, watching the movie with her.

   It may be that the two of them discussed the patient's case once in the afternoon, and it's time to quarrel and argue once. Now watching the film can be more silent, which is golden.

  Other teachers and bosses, bombarded by the information of this patient's serious illness, their brains were a little irritated, and they stood by and argued endlessly.

   "I'm in a coma. This MR film is definitely not accurate. If I take another picture, the dissection should be torn to the innominate artery or the left common carotid artery."

  The innominate artery and the left common carotid artery, as mentioned before, are branches from the aortic arch and connect important cerebral vascular trunks. It can be said that once something goes wrong with these two blood vessels, the brain tissue will be cut off from blood nutrition. Cerebral ischemia caused the patient's disturbance of consciousness, and the direct clinical manifestation was that the current Axi mother was in a coma.

  How does aortic dissection cause the "broken blood" of the innominate artery and the left common carotid artery?

   Here are some other features of aortic dissection. It is similar to an aortic aneurysm: it is afraid of bleeding like a balloon burst. The formation of a spherical hematoma compresses nearby organs and tissues. For example, compression of the nearby esophagus can cause difficulty in swallowing, and compression of the superior mesenteric artery may lead to intestinal necrosis.

   But obviously, it is not the reasons mentioned above that aortic dissection can widely cause various symptoms of "break-off" of organs. The difference between aortic dissection and aortic aneurysm is that the adventitia is not ruptured, and blood runs into the dissection.

  There is blood in the dissection, which will squeeze the original true lumen of the blood vessel, causing the blood flow in the true lumen to drop sharply. The most intuitive clinical manifestation is the blood pressure difference between the two limbs of the patient. There is less blood in the true lumen of the limb on the side that is compressed by the dissection, resulting in low blood pressure measured.

   Going a little deeper, this low blood pressure is by no means a good thing. Doctors all know that this means that a certain part of the body is ischemia.

   This is indeed the case, even if the blood is not lost in the dissection, in fact, after this part of the blood escapes the dissection, the blood flow in the true lumen of the blood vessel is less. The dissection is a fake, not a true blood vessel, it is not connected to the main blood vessels of the organ, and blood needs to go from the true lumen to the organ for organ nutrition. The blood that ran to the dissection slipped away and failed to reach the organ. This will "break" the blood vessel segment where the dissection occurs. As long as the main vascular trunks supplying blood to other organs are related to this segment of the dissecting blood vessels, they will all be "broken". These organs are naturally in a state of ischemia, which is also known as poor perfusion and hypoperfusion in medicine.

   For example, if one or both renal arteries are involved, the patient will experience severe renal failure with anuria and hematuria.

   Involvement of the celiac artery may lead to irreversible consequences of liver and spleen infarction.

   Involves the lower extremity arteries, ranging from cold to severe pain and necrosis. This is the reason why Ahi's mother's limbs are cold.

   "Blood" the spinal cord, and there may be symptoms in the corresponding spinal cord segment, ranging from lumbar pain to severe paraplegia.

   The left common carotid artery of the innominate artery mentioned above was "pinched", and central nervous system symptoms appeared.

   (end of this chapter)

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