I can see the status bar

Chapter 117 Further Study

"How to say?" Sun Li'en panicked, and subconsciously asked Cao Yanhua, "Should I call Lao Wu first?"

Cao Yanhua frowned and looked at it for a long time, then shook his head, "We'll wait for the blood results to come out. If it's really an ectopic pregnancy, at least β-HCG has risen." He looked at the strong echo group on the screen, and his eyebrows frowned as if water could be wrung out. "It doesn't look like an ectopic pregnancy, at least to me."

Both of them panicked.This kind of B-ultrasound image is not what you often see in the emergency department.Cao Yanhua took out his mobile phone and prepared to call Director Liu to help out, but Sun Lien immediately thought of Brother Video Keluo, who he had partnered with before.After calling to invite Brother Luo to come for a consultation, Sun Li'en thought about it and sent another message to Xu Yourong.This strange symptom was beyond the scope of his knowledge reserves, and it was the right choice to seek help from a higher-level physician.

"Roast gluten!" As soon as he sent the message, Xu Yourong immediately came back, "Understood, I'll take Zhou Ce over there."

The position of the strong echo group is also quite close to the kidney, so it makes sense for Zhou Celai to consult with him.Thinking of this, Sun Lien simply called the pediatrics department again.Director of Pediatrics Qian Hongjun had just finished his outpatient clinic and was about to go home when Sun Lien called him over.

"It's very lively." Liu Tangchun squinted his eyes and walked into the emergency room. Looking at the doctors in the emergency room, he felt that things might be troublesome.He saw Sun Lien standing with Cao Yanhua, so he simply asked, "Lien, what's the situation?"

"Director Liu." Sun Li'en nodded, and briefly introduced the basic situation he heard. "The situation is quite special. Neither Dr. Cao nor I can confirm the type of the echo group, so I invite you to diagnose it."

Liu Tangchun walked to the bed and asked for the inspection report just printed out, "If it was just an echo group, you wouldn't have called me here." He glanced at the video report and continued to Sun Lien, "Do you think this Does the unknown mass have something to do with her mental state?"

"At present, I can only make this kind of inference." Sun Li'en said in a deep voice, "But I don't understand why the mass in the lower abdomen can cause a nerve reaction—it doesn't look like a paraneoplastic syndrome."

Paraneoplastic syndrome is an immune disease caused by a primary malignant tumor.When a primary malignant tumor appears in the human body, after the immune system recognizes the cancerous cells, a large number of secreted antibody cells begin to fight the tumor.And these antibody cells floating in the blood may mistakenly attack other organs that the cancer has not yet affected, and cause symptoms that have nothing to do with the tumor.Moreover, this syndrome basically appears before malignant tumors are discovered. Although the symptoms are serious and extremely annoying, they are one of the important clues for early detection of cancer.

And this is why Sun Lien directly ruled out paraneoplastic syndrome—if it is a malignant tumor, it is almost certain to be at an advanced stage with this size, and it has already metastasized.In this case, Ji Youfu may have developed other symptoms long ago, so she would not be sent to the emergency department by the teacher because of her daze.

"It doesn't look like an ectopic pregnancy." Brother Luo, who was called for consultation, put his hands behind his back, stretched his neck and leaned over to look at the B-ultrasound report printed out in Liu Tangchun's hand. "Ectopic pregnancy usually ruptures around [-] days, leading to acute abdomen and massive hemorrhage. The appearance of primitive cardiac pulsation means that the embryo has grown for at least eight weeks, and the time is wrong. And the eight-week embryo is not so big."

Director Qian Hongjun of the Department of Pediatrics rubbed his bald head and put forward a new point of view, "Could it be ovarian cysts?" Although ovarian cysts mostly occur in women of childbearing age, there are also reports of children suffering from ovarian cysts.Ovarian cysts on ultrasound showed hyperechoic masses, and although the odds of this occurring in a 13-year-old girl were low, it did seem possible.

"The images are correct, but the symptoms are not." Sun Lien continued to shake his head and denied other people's diagnostic opinions, "The teacher reported that the little girl had a personality change two months ago. Can ovarian cysts cause mental symptoms?"

Xu Yourong suddenly opened her mouth and said, "Teratoma?" She pointed to the mass, "It is possible for a teratoma to have primitive cardiac pulsations, and it can be asymptomatic for a long time. When the teratoma matures, it may triggers an immune response. And the immune cells attack her brain at the same time..."

"You mean..." Liu Tangchun suddenly realized, "Autoimmune encephalitis?"

Autoimmune encephalitis is a very strange disease.Although it was not recognized for the first time until 07, and although it was included in the first batch of national rare disease lists in 18, its incidence rate is not low.In fact, a large part of encephalitis that was previously treated as "encephalitis of unknown origin" was its various classification manifestations.Since 10, my country has confirmed the first case of autoimmune encephalitis, and then this disease has been introduced into the knowledge system of many neurologists.Since 10 years, a large number of patients with autoimmune encephalitis have been diagnosed every year.According to recent statistics, the incidence of autoimmune encephalitis has actually exceeded that of any virus that may cause viral encephalitis.

"The onset of autoimmune encephalitis may or may not be combined with a tumor. If it is combined with a tumor, it is a teratoma." Xu Yourong continued to explain that there was something wrong with Sun Lien's diagnosis.But it's not his fault.In fact, the correlation between autoimmune encephalitis and teratomas is no more than 40%.Moreover, the research and understanding of this disease in the entire medical community is still insufficient, so it is reasonable for Sun Lien not to be able to diagnose it.

"So..." Sun Li'en pointed to the strong echo block on the report, "This...is a teratoma?" He was still thinking about the characteristics of this echo.If it is indeed a teratoma, Ji Youfu's symptoms are actually not too serious.As a common type of germ cell tumor, the progression rate of teratoma is less than 2%.Although it caused autoimmune encephalitis, it was not fatal.

Brother Luo said in a big way, "For this kind of thing, you can find out after an examination. You can write a bill and send it to our department for an emergency MRI, so you can find out?"

As Ji Youfu's attending doctor, Cao Yanhua prescribes an examination is easy.It's just that Ji Youfu's parents haven't arrived at the hospital yet, and the only person who can sign is her head teacher.Considering that autoimmune encephalitis is not a particularly urgent disease, he simply decided to wait until the imaging confirmation, and wait for the blood test report to come out first.

After arriving at an almost clear diagnosis, Liu Tangchun did not leave the emergency room in a hurry, but instead pulled Sun Lien into the small conference room of the emergency room and asked, "Do you feel a little psychologically lost?"

Sun Lien was still immersed in the excitement of encountering a disease that he had hardly heard of. He shook his head and looked at Liu Tangchun in a daze. He didn't know what Director Liu meant when he suddenly said this to him.

"You boy." Liu Tangchun knocked on the table, a little dissatisfied, "What can I hide from you? Doctor, it's normal to make a diagnosis when the results of the imaging are not clear and the clues of other test reports are lacking. Yes. Qian Hongjun thought it was an ovarian cyst. Nothing to be ashamed of!"

Only then did Sun Lien realize that Liu Tangchun was worried about himself, he couldn't tell whether to laugh or cry, "Director Liu, I'm just a Gui Peisheng. Although it's not appropriate to say that, the inexperienced Gui Peisheng made a mistake in this kind of diagnosis. It's pretty normal, isn't it?"

"I'm mainly worried that you've been used to going smoothly these days, and you can't accept a sudden problem." Liu Tangchun shook his head with a smile, "However, if you dare to directly say that there is a problem with Qian Hongjun's diagnosis, you already have the courage to make a diagnosis. .Good!"

Sun Li'en was a little embarrassed. When he rejected Qian Hongjun's diagnosis just now, he didn't think about it.It's just that I simply feel that Qian Hongjun's reasoning and symptoms don't match up.

"Before you dragged the pilot out of the helicopter and avoided a possible crash. The municipal government attaches great importance to this, and they are planning to commend you." Liu Tangchun said suddenly, "I would like to ask you , do you have any idea of ​​continuing to study in our academy?"

Sun Lien was taken aback, "But... I didn't sign up for this year's postgraduate exam..."

Liu Tangchun waved his hand and interrupted his speech, "If you want to do it, it must be recommended by the college." He looked at Sun Li'en and asked casually, "If you can be exempted from the test, do you want to enter neurosurgery? Follow Liu Pingchuan, or come to me and be a fellow disciple with Zhou Jun?"

　Those of you who guessed the cause of the disease and guessed it right...are they all monsters? !

　　
　
(End of this chapter)