Jamplis Robert P, Friedman Lucas, Adhikari Srikar
College of Medicine, University of Arizona College of Medicine-Tucson.
Department of Emergency Medicine at Riverside Community Hospital, University of California, Riverside.
Cureus. 2017 Dec 17;9(12):e1956. doi: 10.7759/cureus.1956.
A 28-year-old male was brought to the emergency department by the Emergency medical services (EMS) after being found unconscious and unresponsive. Upon arrival, he was hypotensive, intubated with a Glasgow Coma Scale (GCS) 3T, without the signs of trauma or the evidence of bleeding. A focused assessment with sonography in trauma (FAST), point-of-care ultrasound (POCUS) was performed, obscuring part of the spleen from the distended stomach, which was filled with the heterogeneous contents, with the internal movement being identified. This was found to be blood after orogastric (OG) tube was placed for suction. The bedside endoscopy confirmed active variceal bleeding. This case illustrates the potential utility of the ultrasound in detecting the upper gastrointestinal bleeding.
一名28岁男性在被发现昏迷且无反应后，由紧急医疗服务（EMS）送往急诊科。到达时，他血压过低，格拉斯哥昏迷量表（GCS）评分为3T，已插管，无创伤迹象或出血证据。进行了创伤重点超声评估（FAST），即床旁超声检查（POCUS），因胃扩张遮挡了部分脾脏，胃内充满不均匀内容物，可见内部有活动。放置鼻胃管（OG）抽吸后发现为血液。床旁内镜检查证实为活动性静脉曲张出血。该病例说明了超声在检测上消化道出血方面的潜在作用。
