Doctor: It's reasonable to perform surgery on yourself.
Chapter 540 Clues, sick toddler!
Chapter 540 Clues! Sick toddler!
Her hair was sparse, her exposed arms also showed signs of slight yellow staining, and one of her calves was slightly swollen. She neither cried nor fussed, allowing Yuan Yu to hold and tease her.
"Look, is my baby very obedient? The previous nanny said that she had never seen such a well-behaved baby." Yuan Yu raised her head, and her dim eyes only shone when she talked about her child.
Xu Qiu didn't speak. He looked carefully at the one-year-old child.
The smile on Yuan Yu's face disappeared instantly. She looked panicked and hugged the child tightly: "Doctor, you... what are you doing?!"
Xu Qiu withdrew his gaze.
Disease diagnosis, which has hit a dead end, finally has a clear direction.
Hereditary liver disease!
Xu Qiu was not sure whether this was the final cause of the disease, but he saw the same yellowish skin in Yuan Yu's children. In addition, they also had symptoms such as neither crying nor fussing, and limb weakness. These are possible liver function injuries. Symptoms that appear…
If mother and child share the disease, of course it depends on heredity.
"Hepatolenticular degeneration."
"Glycogenosis."
"There is also familial hyperbilirubinemia..."
First, hepatolenticular degeneration can be ruled out.
This is an autosomal recessive copper metabolism disorder. Simply put, it means that there is a problem with the copper metabolism of the patient's body, resulting in cirrhosis and brain degeneration, mainly damage to the basal ganglia.
It's a good thing if it's hepatolenticular degeneration, which is one of the few neurogenetic diseases that can be cured.
However, Yuan Yu's son is obviously not.
In addition to liver abnormalities, hepatolenticular degeneration is a disease that affects the brain and central nervous system. Therefore, patients often have symptoms of damage to the extrapyramidal system, such as chorea, athetosis, or dystonia.
This kind of patient is easy to distinguish. They often have mouth opening and drooling, and their facial expressions are extremely weird.
In addition to this, the more important and typical sign is the corneal K-F ring.
Its essence is that copper ions are deposited in the corneal Descemet's membrane, forming a green-brown or golden-brown strip at the junction of the sclera and cornea.
But Xu Qiu didn't see it.
"Doctor, say something, I'm scared!" Yuan Yu almost cried.
The flat-nosed, flat-headed relatives and others were also attracted by the movement here. They temporarily gave up the confrontation and stared at Xu Qiu.
Xu Qiu asked: "You said before that the child was hospitalized in the middle of the month? What diagnosis did the doctor give at that time?"
"Bronchitis..." Yuan Yu's voice trembled.
She has been sick several times and has seen all kinds of situations in the emergency department.
Doctors often turn a blind eye to cases where there is nothing wrong with them, or they are minor ailments that are not worth a second look at.
And it wouldn't be great if Xu Qiudu came to ask specifically.
Yuan Yu would rather not have a doctor take care of her.
"bronchitis?"
Young children have poor immunity and are indeed prone to bronchitis if their bronchial tubes are infected.
"Look at the legs."
After Xu Qiu finished speaking, he lifted up the child's trouser legs again, pinched and pressed, and found that there was indeed edema.
"There is also liver damage."
When liver cells are damaged, the body cannot produce sufficient amounts of protein. In this case, in order to balance the protein content inside and outside blood vessels, fluid in the blood will flow into tissue cells, causing swelling.
Of course, there are many clinical causes of edema.
The most common ones include cardiogenic edema, hepatic edema, and nephrogenic edema.
There are differences between these three.
For example, cardiogenic edema usually starts from low-hanging parts of the body, such as the feet and ankles, and then spreads throughout the body as the degree of heart failure worsens.
Although hepatogenic edema may also cause generalized edema, the head, face, and upper limbs will not be swollen.
Nephrogenic edema is just the opposite. It swells the eyelids and other parts of the body, as well as the perineum. The more distinctive feature is that the edema has a time distribution pattern, is more severe in the morning, and can quickly develop throughout the body. Sexual edema.
However, real clinical practice is not so rigid. It is impossible to judge the source of edema solely by the nature of it. It is necessary to look at the overall situation.
For example, cardiogenic edema is accompanied by palpitations, asthma, pleural effusion, ascites, etc.; hepatogenic edema is accompanied by jaundice, hepatomegaly and spleen, spider nevi, varicose veins, etc.
Judging from the child's condition, he undoubtedly has hepatogenic edema.
…
Hepatolenticular degeneration was initially ruled out, and Xu Qiu continued brainstorming.
"Does bronchitis have something to do with this?"
After thinking for a moment, he shook his head.
Neither hepatic glycogen accumulation nor hyperbilirubinemia will affect the respiratory system.
Or in other words, as long as the liver is damaged, the patient's immune function will inevitably decline, and the probability of contracting infectious diseases such as bronchitis will naturally increase exponentially.
Therefore, Xu Qiu directly rejected this direction.
Bronchitis should not be directly related to the origin of liver disease.
Glycogenosis?
Xu Qiu conducted a detailed examination on the child.
"The development seems to be a bit delayed..." Xu Qiu raised an eyebrow.
He rarely dabbled in operations on infants and young children, and he mostly stayed at theoretical knowledge in this area. He could only perform a cranial separation operation.
"Go and ask Li Xue to come." Xu Qiu said.
Li Xue is from the obstetrics and gynecology department, and there are no separate clinics for gynecology and obstetrics.
After saying that, Xu Qiu continued to check.
If there is developmental delay, it is consistent with the symptoms of glycogen storage disease.
However, after careful examination, Xu Qiu did not find the common subcutaneous xanthomas of the disease in the child.
"Have you tested blood sugar?" Xu Qiu asked.
Yuan Yu was so nervous that his palms were sweating, "No, no..."
"Test one." Xu Qiu said.
Liu Susu came over to give him a needle, and the result came out after a while, "5.7mmol/L."
"No hypoglycemia..."
Xu Qiu turned and asked, "Does he have diarrhea?"
"No, no, my baby's bowel movements are quite regular."
Seeing that Xu Qiu hadn't solved Yuan Yu's problem yet, and ended up dragging his son's problem, the flat-nosed man became angry again. He grabbed the child and said, "You keep asking questions here, but you can't get any results after asking for a long time. You are simply a quack!"
Seeing this, the flat-headed relative who was suppressed also had a teasing look on his face and said, "Your hospital is not good. Our Jing'an First Hospital... The doctors in our hospital are much better than you!"
Although he quickly changed his words, everyone still caught the name of the hospital.
"Jing'an First Hospital?" Liu Susu narrowed her eyes.
There is quite a lot of cooperation and exchange between the hospital and Linhai First Hospital. In order to send doctors to study and train here, many directors in the hospital want to build good relationships with Wang Ping and Wang Shengde. Several times, they brought their director teams to observe Xu Qiu's surgery...
It can be said that most of the directors of Jing'an First Hospital are familiar to Liu Susu.
But she has no impression of the flat-headed relative in front of her!
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