Doctor Zhao, help!

Chapter 138 We Are Professionally Trained

"So you're like this because you sneezed?"

After hearing what the fat boy said, Zhao Sheng also said to the thin boy with a crooked neck in a daze.

Song Wei, who was standing aside, felt like she couldn't help but laugh, but she held it back immediately.

We are trained not to laugh no matter how funny it is unless we can't help it.

Next, Zhao Shengcai learned the cause and effect of the incident from the crooked-necked boy.

It turned out that on a sunny morning, a young man who was sitting in the dormitory using his mobile phone to watch a young lady dancing suddenly smelled a very strong smell of cologne coming from beside him. He, who already had allergic rhinitis, suddenly felt... Feeling like sneezing.

Maybe because he didn't have paper at hand or maybe he didn't want to make a loud noise, he suddenly pinched his nose and closed his mouth tightly in an attempt to swallow the sneeze.

However, something unexpected happened. Instead of suppressing the sneeze as expected, the big sneeze "exploded" on the young man's neck.

According to the young man's oral account, there was a loud crackling sound from the back of his neck, as if his neck had exploded.

The young man originally thought his head had exploded, but after praying for a while he found that there was no change except for his neck being a little swollen.However, not long after, the young man found that he suddenly began to have difficulty swallowing and his throat began to hurt.

Only then did he feel that something was wrong, and the fat boy, who was the culprit, immediately took the crooked-neck boy to the emergency room.

Although he was shocked by the young man's bizarre experience, Zhao Sheng also conducted a detailed examination of the young man.

After examination, the boy's vital signs were stable, with no stridor or other symptoms of respiratory distress, fever, nausea or vomiting.

There was no recent history of iatrogenic neck operations or cervical spine trauma, and she had not eaten sharp food before the onset of the disease.

The physical examination revealed swelling and tenderness in the young man's neck, especially on the right side. Crepitus could be heard extending from the front of the neck to the sternum.

"Doctor, is he all right?"

He laughed, but as a good brother of the crooked-necked boy, the fat boy also asked nervously.

Seeing the fat boy's concerned expression, the crooked-necked boy looked hard at his brother sleeping on his upper bunk, with a hint of emotion in his eyes.

"First do a CT scan of the neck and chest to see if there is pneumothorax and bronchial damage."

Zhao Sheng thought for a while and said.

Although I have never encountered a situation where a young man sneezed too hard and caused subcutaneous emphysema in his neck before, Zhao Sheng had also seen cases of pneumothorax due to ruptured lungs caused by sneezing.

Therefore, the young man’s current situation can also be handled in this way.

"Thank you doctor."

The young man tilted his neck and said with some difficulty.

Next, the fat boy accompanied the crooked-necked boy for a check-up.

When the crooked-necked boy went out, Song Wei could no longer hold back her smile.

"How could there be such a person who sneeze and swells his neck..."

Song Wei said.

"Actually, sneezing causes quite a lot of stress, but many people don't realize it."

Zhao Sheng thought for a while and said.

As the weather gets colder, we can see all kinds of "sneezes" in public places. Some are sneezed directly regardless of other people's eyes, some are sneezed carefully and run to no one's place, and some are even suppressed to reduce the impact. Go back.

So what is the right way to sneeze?

It is generally believed that sneezing is to forcefully expel foreign matter on the nasal mucosa from the mouth and nose. The airflow speed produced by sneezing is about 30 to 100 meters/second. The speed of our Fuxinghao is 350 kilometers/hour, which is almost 97 Meters/second, after such a comparison, one can imagine the power of a sneeze!
Moreover, the pressure generated by sneezing can reach 1 kilopascal in the nasal cavity.If you hold back a sneeze, the pressure can increase by 5 to 24 times.

If such a large pressure cannot find an outlet, it will be transferred to the upper respiratory tract, lower respiratory tract, skull top, eye sockets, ears and vascular system, causing corresponding damage.

Even in extreme cases, there are cases where there is no way to vent such a huge pressure, causing eyeballs to protrude. "Just don't hold it in."

Song Wei said in summary.

"Yes, holding it back is not good for your health. If you feel something, you should release it appropriately."

Zhao Sheng was sorting out the outpatient medical records. Hearing this, he said casually.

"Ah? Doctor Zhao, I said sneezing, what are you talking about?"

Song Wei said somewhat caught off guard.

"I'm also talking about sneezing, otherwise..."

Zhao Sheng said.

Eleven in the morning.

The crooked-necked guy came with the fat guy with the test results.

"Doctor, the results are out."

The fat boy carefully helped the crooked-necked boy sit down, then handed the inspection report to Zhao Sheng and said.

It can be seen that he takes good care of the crooked-necked boy. After all, he is the [culprit]!

"it is good."

Zhao Sheng nodded, took the neck and chest CT report sheet and read it carefully.

Well, there are streaks of air in the retropharyngeal area, extensive emphysema in front of the trachea, extensive soft tissue emphysema in the neck, the base of the skull extending to the T9 cone, and pneumomediastinum.

After carefully looking at the examination results, Zhao Sheng had some doubts. There was no pneumothorax, no bronchial damage, and the lung parenchyma and esophagus were normal. So, where did the gas come from?
"Give me the film."

Zhao Sheng said to the fat boy.

Just looking at the inspection report given by the imaging department, although it is generally accurate, the details may not be fully written out.

After all, people are not machines. For a neck or chest CT, sometimes people will miss some subtle points.

"Ok."

The fat boy nodded repeatedly and handed the paper bag in his hand to Zhao Sheng. The paper bag contained CT films of the neck and chest.

Zhao Sheng took the film, put it on the reading stand, and read it very carefully.

While Zhao Sheng was watching the film, a strange feeling arose. As he stared at the film, the image formed by the tomography gradually restored into a very complete neck and chest in Zhao Sheng's mind. [-]D scanning imaging.

This imaging is more detailed than the 3D imaging currently done by the imaging department.

It's here!
Zhao Sheng had an idea and made a discovery instantly.

There's something wrong with the patient's right piriform fossa!

The piriform fossa on the right side has a very imperceptible bulge compared to the left side, which is very likely to have a tissue fistula.

Yes, the piriform fossa has the structural characteristic of lacking longitudinal muscle layer reinforcement. When the boy sneezes, he pinches his nose and closes his mouth, which causes the pressure in the pharynx to rise suddenly. The piriform fossa is perforated under the strong pressure, and the gas passes through the piriform fossa. The perforation goes under the skin causing a range of symptoms.

The cause of this disease is really hidden enough. If Zhao Sheng hadn't discovered this subtle change, others might not have been able to discover it.

"Doctor, how are you?"

The fat boy couldn't help but feel a little uneasy when he saw Zhao Sheng looking at it again and again, looking very serious.

The crooked-necked boy also tilted his head and looked at Zhao Sheng nervously, although he looked a little funny.

(End of this chapter)