There is an old Chinese saying that “a living person can be suffocated by urine”, which means that people should find a way to solve problems no matter what difficulties they encounter and will not sit around and wait for death. But this saying should be changed to “a living person can be suffocated by urine”, because I did encounter a patient like this.
One day when I was checking the ward, I met an elderly patient who was admitted to the hospital with “abdominal pain to be investigated” and had undergone appendectomy three years ago due to “appendicitis”. The patient had a history of appendicitis. The outpatient physician considered that the patient had a history of previous surgery and did not exclude intestinal adhesions, but the abdominal plain film examination did not reveal any liquid-gas planes and the patient was able to defecate on his own, so he was admitted for further observation and treatment. I examined the patient and found that the lower abdomen was relatively full, with turbid percussion and mild pressure pain, but no rebound pain or muscle tension, and the bowel sounds were basically normal. When I asked him about urination in detail, he replied that he urinated once in about 10 minutes, and that he only urinated a little bit each time. The above symptoms and signs basically led to the diagnosis of “acute urinary retention”, so I immediately explained the patient’s condition and ordered the placement of a catheter, but the patient obviously showed a distrustful expression, saying that he was not unable to urinate but urinated a lot and had to urinate once every 10 minutes. I explained in detail that this kind of urinary retention is also called “filling incontinence”, which is like a teacup full of water, and if you add a little bit more, it will overflow, that’s why you have to urinate a little bit every now and then. However, the patient insisted that he did not believe in it and refused the catheterization treatment. Since the patient spoke Cantonese, there were some difficulties in communication, so we immediately asked another doctor who spoke Cantonese to explain the patient’s condition in detail, but the patient just did not believe it and refused all urinary measures. However, the patient refused to believe it and refused all urinary measures. However, after lunch, the patient suddenly collapsed while walking in the corridor and was immediately resuscitated. The catheter inserted during the resuscitation process drew out about 1500 ml of urine.
The cause of the patient’s death was considered to be due to a significant increase in vagal excitability due to urinary retention for several consecutive days that inhibited the sympathetic nerves of the heart, resulting in a normal sinus rhythm bradycardia thus inducing cardiac arrest.
A stubborn old man died because of his distrust of doctors, leaving his family with sudden grief and a million regrets.