This is part 3 of the series. It happened when I worked as a Family Medicine trainee and rotated to the Orthopaedic Department of the Queen Elizabeth Hospital (QEH). I was on-call that day and I was in the Spine Team of the Department. An evangelist was admitted to the Department because of low back pain. The AED had done all the preliminary investigations and had written down the provisional diagnosis of mechanical low back pain in the admission sheet.
The patient was quite well and walked around in the ward. The pain could be controlled by the pain-killers. All the investigations were done at the AED and the case was even screened by my supervisor and there was no further doubt in the provisional diagnosis. I was suddenly paged by the ward nurse a few hours later and it was informed that this patient had lost his consciousness while he was in the restroom. I arrived at the scene immediately and carried out the active resuscitation on the patient. Unfortunately, he passed away eventually despite the resuscitation. Out of my expectation, the family was quite calm and accepted the fact that he was passed away. They did not make any complaints to the hospital. But the patient's diagnosis remained unexplained.
The final pathological diagnosis of the patient was ruptured abdominal aortic aneurysm (AAA). Obviously, this was a silent case because there was no any detectable signs in the patient.
My father, who was previously a dentist, always told me that he had some bad personal experiences in AAA patients and he always said that the signs of AAA were always difficult to detect. The response of the patient's family was quite out of my expectation because, to be honest, the sudden death of a close relative would usually trigger some intense reaction.
I'm busy working on my blog posts. Watch this space!