Back in the emergency room, Sun Lien continued to carry out various rescue measures while issuing a brand new medical order.

"Urgent check for blood amylase and urinary amylase?" After hearing Sun Lien's doctor's advice, the nurses rarely stopped their work and confirmed again, "Are you sure?"

"Confirm." Sun Lien nodded and added, "Push B and give her a pancreatic color ultrasound."

"She has diabetes? She looks like she is of type 2 at this age." Yuan Ping'an saw the abnormal behavior of the nurses from afar. He rushed to the scene immediately after hearing Sun Lien's words. "There is no history of trauma and no Cullen signs, why does pancreatitis occur?"

Cullen's sign is a special epidermal symptom of acute hemorrhagic necrotizing pancreatitis. Necrotic necrotic tissue mixed with pancreatic juice, enters the subcutaneous fat layer along the tissue gap, and then begins to digest fat, which leads to rupture and bleeding of capillaries. This forms a special manifestation of large areas of cyanobacteria on the abdominal skin.

Cullen symptoms do not necessarily appear in all cases of acute pancreatitis, but all Cullen symptoms mean that the patient has severe acute pancreatitis.

Trauma is another high-incidence factor in acute pancreatitis. After the pancreas is damaged, the pancreatic duct rupture and pancreatic juice spillover is likely to lead to acute and severe pancreatitis.

In the absence of a patient complaining about severe upper abdominal pain, these two conditions are the main factors for emergency doctors to determine whether the patient has pancreatitis. Yuan Ping'an did not find any situation related to these two factors, so he naturally couldn't understand why Sun Lien felt that the patient might have pancreatitis.

Because the status bar indicates that pancreatitis occurs earlier than all other symptoms, Sun Lien of course couldn't say it. But he also had his own set of perfect theory. He showed Yuan Ping'an the small receipt for purchasing medicines he got, "The patient himself has a high sugar and high fat diet, and he bought these drugs from the pharmacy the day before the onset."

Yuan Ping'an took the list and looked at it, "These are all gastrointestinal medications..."

"It's obvious that they were recommended to her by the pharmacy clerk," Sun Lien explained. "The pharmacy clerk was not sure about the cause of her discomfort, so based on his 'experience', he also recommended to her drugs that can treat gastrointestinal ulcers and food accumulation."

Yuan Ping'an suddenly realized when he heard this, "So she had problems with upper abdominal distension and pain before."

Talking to smart people is easy. Sun Lien nodded happily, "The problem of upper abdominal distension and pain is actually a symptom of pancreatitis."

"Isn't that right?" the nurse next to him said in confusion, "The pancreatitis patients I have seen are almost in pain. The swelling pain that can buy medicine by yourself is definitely not as painful as acute pancreatitis."

"Not all cases of acute pancreatitis will have severe pain," Yuan Ping'an explained. "There is a special type of acute pancreatitis called 'painless pancreatitis'. Previously, this disease also had an alias for 'sudden death pancreatitis'."

The reason why painless pancreatitis has such a cold name is mainly because it is really special. Patients do not have symptoms in the traditional sense, so it is difficult for doctors to find out its existence before the patient dies. The diagnosis of such cases is often confirmed by an autopsy after the patient dies due to illness.

Painless pancreatitis is not completely free of pain. In fact, they can still bring about a series of discomfort feelings including upper abdominal distension, bloating, etc. But this is also the difficulty in diagnosis of this disease - few doctors associate pancreatitis with this symptoms. Patients will not think they have any great disease. They often choose to ignore or take medication on their own to try to relieve the symptoms. So that patients with painless pancreatitis often delayed for a long time when they are sent to the hospital. When doctors discover, their symptoms will be much heavier than those of ordinary acute pancreatitis patients. It will be very difficult to treat such patients.

Zeng Jing was lucky. Her painless pancreatitis did not directly drag her into the abyss of death. Her usual high-sugar and high-fat diet saved her life to some extent. Because of the outbreak of painless pancreatitis, Zeng Jing's insulin content quickly dropped to an unacceptable level. Such insulin content was obviously unable to cope with the high-sugar and high-fat diet she was accustomed to. After four times of milk tea for two consecutive days, plus a normal diet, Zeng Jing's blood sugar content soared. The high blood sugar level affected her body's ability to utilize blood sugar. A large amount of fat began to decompose into ketone bodies, which eventually caused ketoacidosis.

A hyperosmotic coma caused by ketoacidosis and hyperglycemia sent her to the emergency room. In the emergency room, there was a very bored Sun Lien who was preparing to find something to do.

The beginning and end of this series of links are connected, and any of them may lead to fatal consequences. When all these conditions are closely combined, Zeng Jing encountered a safe path that could save her life in countless death traps.

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Because the pancreas is too deep, the ultrasound doctor who was asked to consult the pancreas was a color ultrasound doctor who was invited to the rescue room to consult. He frowned and looked again and again, and then said, "This pancreatic edema is very serious... There is a high possibility of acute pancreatitis, but ultrasound is indeed not easy to see clearly. It is best to take a CT."

Sun Lien nodded and then issued a new medical order, "Physical saline combined with methanesulfonic acid and 100mg of caliper, drop it in two hours. Somatostatin 250 micrograms, injection in three minutes."

The nurses turned to dispensing medicine, while Sun Lien was in a new confusion. Should she immediately send Zeng Jing to the CT room for examination, or wait until her acidosis is slightly relieved and her vital signs are relatively stable before sending her? Or should she directly send the person to the operating room and perform an emergency abdominal lavage on her?

After a little consideration, Sun Lien immediately decided to take the fastest and most decisive measures to intervene. Unlike ordinary acute pancreatitis, painless pancreatitis is naturally called sudden death pancreatitis because it is more dangerous. Phospholipase A released by the pancreatic tissue of patients with sudden death pancreatitis will decompose lecithin into lyselectin, thereby inducing ARDS (acute respiratory distress syndrome) and pulmonary embolism. The myocardial inhibitor released by pancreatic necrosis will lead to acute heart failure. Once the pancreatic necrosis bleeding stimulates the abdominal solar plexus, it may lead to reflex heartbeat inhibition, resulting in cardiac arrest.

The use of conventional acute pancreatitis drugs alone may not take effect before these fatal consequences occur. More radical measures must be taken immediately so that the situation can be reversed before symptoms appear.

Sun Lien walked out of the rescue room again. This time, what he needed was not clues, but direct authorization for tracheal intubation and emergency surgery.
Chapter completed!