This miracle doctor just wants to be fired!

The ultrasound doctor who arrived was a middle-aged woman wearing a mask and hat, making it impossible to see her face. She was accompanied by a young female assistant.

The ultrasound doctor did not immediately examine the girl, but instead began asking about her medical history while turning on the machine.

"18 years old, massive bleeding?"

The female ultrasound doctor frowned, looking at the young girl on the hospital bed, somewhat surprised.

"The patient said she doesn't have a boyfriend, so..."

Zhou Cheng didn't finish speaking, but the female ultrasound doctor immediately understood.

"Let's not speculate yet, let's see the ultrasound results first." The female ultrasound doctor skillfully turned on the ultrasound machine, and the screen lit up instantly.

She took out another packet of disposable coupling gel, tore open the packaging, squeezed out an appropriate amount of transparent gel onto the tip of the probe, and said to her assistant, "Adjust the patient's position, knees bent, supine, hips slightly elevated, expose the lower abdomen, be gentle, and don't touch the venous access."

The assistant carefully helped the girl adjust her posture.

Zhou Cheng pulled the curtain next to the hospital bed and stood outside.

He still needs to avoid this special kind of examination.

The female ultrasound doctor walked to the examination bed with the probe and first applied a layer of coupling gel to the girl's lower abdomen. "It's a little cold, bear with it."

Then, she gently placed the probe above the girl's pubic symphysis and slowly moved it.

A clear grayscale image immediately appeared on the ultrasound screen.

The female ultrasound doctor kept her eyes glued to the screen, constantly adjusting the probe angle and depth while simultaneously reporting the data aloud.

"The uterus is anteverted, measuring approximately 5.2cm × 4.8cm × 3.6cm. The myometrium has a uniform echogenicity, and the endometrial thickness is 0.8cm."

"No obvious gestational sac echo was observed, and there was no abnormal fluid accumulation in the uterine cavity. Incomplete miscarriage is temporarily ruled out."

As she spoke, she moved the probe toward the bilateral accessory areas, carefully observing each cross-section.

"The left ovary measures 3.0cm x 2.1cm, and the right ovary measures 2.8cm x 1.9cm."

"No abnormal masses were found in the bilateral adnexal regions, and there were no typical signs of tubal looping in ectopic pregnancy."

"There was no free fluid in the pelvic cavity, so the possibility of corpus luteum rupture or ectopic pregnancy rupture can be temporarily ruled out."

Zhou Cheng stood outside the curtain, listening to the ultrasound doctor's report, his brows furrowing deeper and deeper.

Ectopic pregnancy, incomplete miscarriage, and ruptured corpus luteum—these common causes of massive bleeding have all been ruled out.

Where exactly is the bleeding point?

The girl is still bleeding, and if the cause cannot be found, her blood pressure cannot be maintained by intravenous fluids and blood transfusions alone.

"How could this be?" The ultrasound doctor frowned. "All the indicators look fine, and we haven't found a clear bleeding point, but the patient clearly has significant bleeding..."

Zhou Cheng stood aside, his mind quickly processing other possibilities.

Could it be dysfunctional uterine bleeding?

Such a large amount of bleeding is not usually as dangerous as functional bleeding.

Or is it damage to the reproductive tract?

But the patient said there was no external injury!

Just then, a passage about "uterine arteriovenous fistula" suddenly flashed through Zhou Cheng's mind.

Unexplained heavy bleeding in young women should raise suspicion of abnormal vascular pathways within the uterine muscle layer.

On ultrasound, it may appear as an abnormally rich local blood flow signal.

Zhou Cheng was also completely bewildered.

He didn't remember ever reading a similar paper, but how did it suddenly appear in his mind?

However, now is not the time to investigate the reasons.

Zhou Cheng suddenly said cautiously, "Teacher, could you please focus on checking the blood flow in the uterine muscle layer? I was just thinking, could it be a uterine arteriovenous fistula?"

The female ultrasound doctor was taken aback.

This condition can also lead to massive bleeding, and routine examinations may easily overlook abnormal blood vessels within the muscle layer.

A uterine arteriovenous fistula can be thought of as a minor malfunction in the uterine blood circulation system.

Under normal circumstances, there should be a sophisticated system called the capillary network between arteries and veins to buffer and transfer blood.

However, when an arteriovenous fistula occurs, it is equivalent to one or more short circuits being mistakenly established between the artery and the vein.

This unnecessary short circuit is the root of the problem!

High-pressure arterial blood, without buffering, flows directly into weak veins, which can easily cause the veins to rupture, resulting in massive bleeding!

The female ultrasound doctor nodded immediately: "You're right, I was only focusing on the structure and didn't pay close attention to the blood flow!"

After saying that, she immediately adjusted the ultrasound mode, switched to color Doppler blood flow imaging, and re-aimed the probe at the myometrium, slowly moving it to explore.

The image on the screen changed instantly; an abnormal colored blood flow signal suddenly appeared in the originally uniform uterine muscle layer.

Within the right wall muscle layer of the uterus, there is a stream of colored blood.

The uterine artery branches directly connect to the vein, forming a clearly abnormal vascular pathway with a significantly increased blood flow velocity.

"There really is a problem!" The female ultrasound doctor's voice carried a hint of surprise. She adjusted the probe angle for further confirmation. "Abnormal arterial and venous blood flow signals are visible in the myometrium of the right uterine wall, exhibiting a high-speed, low-resistance pattern, consistent with the ultrasound findings of a uterine arteriovenous fistula!"

"This should be the source of the bleeding; the fistula ruptured, causing a large amount of blood to flow into the uterine cavity and then out below!"

Although Zhou Cheng didn't see the ultrasound screen, he finally breathed a sigh of relief when he heard the voice of the ultrasound specialist.

It perfectly matched the information in the literature I had in mind; now I've finally found the cause of the illness!

While quickly capturing and saving key images, the ultrasound technician said to Zhou Cheng, who was standing outside, "This type of uterine arteriovenous fistula is indeed rare. Thanks to your reminder, otherwise I might have missed it!"

A few minutes later, the curtain next to the hospital bed was pulled open.

The female ultrasound doctor deftly operated the instrument, then wrote a brief ultrasound report by hand and handed it to Zhou Cheng.

The report clearly states that there is an arteriovenous fistula in the right myometrium of the uterus, accompanied by active bleeding!

"Please get a gynecologist for a consultation immediately. This situation requires interventional embolization treatment as soon as possible to stop the bleeding and close the fistula!"

Zhou Cheng took the report and thanked him repeatedly: "Teacher, we have already called for an emergency gynecological consultation, they should be here soon."

"Okay, that's all for now." The female ultrasound doctor nodded. "I'll be going now."

"Yes, thank you, teacher."

The female ultrasound doctor walked ahead, with her young assistant pushing the ultrasound machine beside her.

The young assistant asked, "Teacher Zhang, this kind of uterine arteriovenous fistula is quite rare, isn't it?"

Dr. Zhang Min, a female ultrasound specialist, nodded: "It's very rare, and people usually wouldn't think of this disease."

The young assistant immediately said, "This young doctor in the emergency department is really amazing. He's not a gynecologist, yet he managed to think of this disease."

Zhang Min glanced back at Zhou Cheng beside the hospital bed and couldn't help but sigh, "Yes, young doctors these days are really getting more and more amazing; they can even think of such a rare disease!"