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Chapter 115 Continue to study

"What do you mean?" Sun Lien was a little panicked. He subconsciously asked Cao Yanhua, "Do you want to call Lao Wu first?"

Cao Yanhua frowned and looked at it for a long time, shook his head, "Let's talk about it when the blood comes out. If it's really an ectopic pregnancy, at least β-HCG will increase." He looked at the strong echo group on the screen, and his eyebrows were as if they could wrinkle water. "At least, in my opinion, this doesn't look like an ectopic pregnancy."

Both of them were a little panicked. This kind of ultrasound imaging is not something that can be seen often in the emergency department. Cao Yanhua took out his cell phone and was about to ask Director Liu to help, while Sun Lien immediately thought about the image that he had been with him before. After calling Luo Ge to come for consultation, Sun Lien thought about it and sent a message to Xu Yourong. This strange symptoms have exceeded his knowledge reserves, and seeking help from a higher-level doctor is the right choice.

"Grilled gluten!" As soon as the message was sent, Xu Yourong came back immediately, "I got it, I'll take Zhou Ce with me."

The location of the strong echo group is quite close to the kidneys, which is reasonable for Zhou Ce to come to the consultation together. Thinking of this, Sun Lien simply called the pediatrics again. The pediatrics director Qian Hongjun had just finished the outpatient clinic and was about to go home, but Sun Lien called him to come over.

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

"Director Liu." Sun Lien nodded and briefly introduced the basic situation he heard. "The situation is quite special. Dr. Cao and I cannot confirm the type of echo group, so I asked you to diagnose it."

Liu Tangchun walked to the bed and asked for the inspection report that had just been printed. "If it was just an echo group, you shouldn't have called me over." He looked at the image report and continued to say to Sun Lien, "Do you think this unknown mass has something to do with her mental state?"

"At present, I can only make this kind of inference." Sun Lien said in a deep voice, "but I don't understand why the clumps in the lower abdomen cause neural reactions - she doesn't look like paraneoplasty."

Paratumor syndrome is an immune disease caused by primary malignant tumors. When the human body develops primary malignant tumors, after the immune system recognizes the cancerous cells, a large number of secreted antibody cells begin to fight the tumor. These antibody cells floating in the blood may mistakenly attack other organs that have not yet been affected by the cancer and cause symptoms that are not related to the tumor. Moreover, this syndrome basically occurs before the malignant tumor is discovered. Although the disease is serious and extremely annoying, it is one of the important clues for early detection of cancer.

This is also the reason why Sun Lien directly ruled out parane tumor syndrome - if it is a malignant tumor, it is basically in late stages and metastasis has long been present. In this case, Ji Youfu may have had other symptoms long ago and would not be sent to the hospital emergency by the teacher because of dazed.

"It doesn't look like an ectopic pregnancy." Luo Ge, who was called to consult, put his hands behind his back, stretched his neck and looked at the ultrasound report printed on Liu Tangchun's hand. "Ectopic pregnancy usually ruptured in about 40 days, resulting in acute abdominal symptoms and heavy bleeding. The appearance of primitive heart tube pulsation means that the embryo develops at least eight weeks, and the time is not as good as the number. Moreover, the embryo at eight weeks is not that big."

Director Qian Hongjun of the pediatric department rubbed his bald head and put forward a new view, "Can it be an ovarian cyst?" Although ovarian cysts often occur in women of childbearing age, there are also reports of ovarian cysts. Ultrasound examination of ovarian cysts is manifested as strong echo masses. Although the probability of occurring in thirteen-year-old girls is very low, it seems that it is indeed possible.

"The image is right, but the symptoms are not the same." Sun Lien continued to shake his head and deny other people's diagnosis. "The teacher reported that the girl had a personality change two months ago. Will ovarian cysts cause mental symptoms?"

Xu Yourong suddenly opened her mouth and said, "Teratoma?" She pointed to the clump, "It is possible that the teratoma will have primitive heart tube pulsation, and it can be asymptomatic for a long time. When the teratoma develops and matures, it may trigger an immune response. The immune cells also attack her brain..."

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

Autoimmune encephalitis is a very magical disease. Although it was not confirmed for the first time until 2007, and although it was included in the first rare disease list in 2018, its incidence rate is not low. In fact, a large part of the encephalitis that was previously treated as "unexplained encephalitis" are its various classification manifestations. Since 2010, my country has confirmed the first case of autoimmune encephalitis, and this disease has been introduced into the knowledge system of many neurologists. Since 2010, a large number of autoimmune encephalitis patients 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 can be combined with or without tumors. If the tumor is combined, it is a teratoma." Xu Yourong continued to explain that Sun Lien's diagnosis was a problem. But this is not his fault. In fact, the correlation between autoimmune encephalitis and teratoma is no more than 40%. Moreover, the entire medical community has insufficient research and understanding of this disease, so it is reasonable that Sun Lien cannot diagnose it.

"So..." Sun Lien pointed to the strong echo block on the report, "Is this... a teratoma?" He was still thinking about the characteristics of this echo. If it was indeed a teratoma, Ji Youfu's symptoms were not too serious. As a common type of germ cell tumor, the deterioration rate of teratoma is about 2%. Although it causes autoimmune encephalitis, it is not fatal.

Luo Ge said, "You can tell if you do a check-up. You can get the order and send us an emergency MRI?"

As Ji Youfu's attending doctor, Cao Yanhua was simple to prescribe the examination. However, Ji Youfu's parents had not arrived at the hospital, and only her class teacher could sign. Considering that autoimmune encephalitis is not a particularly urgent disease, he simply decided to wait for the imaging confirmation first, and wait for the blood test report to come out before talking about it.

After obtaining an almost clear diagnosis, Liu Tangchun did not rush to leave the emergency room, but instead pulled Sun Lien to the small conference room of the emergency room and asked, "Do you feel a little psychological gap?"

Sun Lien was also immersed in the excitement of encountering a disease that he had almost never heard of. He shook his head and looked at Liu Tangchun in a daze, not knowing what Director Liu suddenly said to him meant.

"You boy." Liu Tangchun knocked on the table and said with some dissatisfaction, "What can I hide with me? As a doctor, it is normal for a diagnosis to make a mistake when the image results are unclear and the clues of other test reports are missing. Qian Hongjun thought it was an ovarian cyst. There is nothing to be ashamed of!"

Only then did Sun Lien realize that Liu Tangchun was worried about himself, and he was amused and crying, "Director Liu, I am just a regular trainee. Although it is not appropriate to say that, it is normal for inexperienced regular trainees to make mistakes in this diagnosis, right?"

"I'm mainly worried that you have been used to being in the smooth flow of the past few days, and you can't accept it if you suddenly have some problems." Liu Tangchun shook his head with a smile, "But you dare to directly say that Qian Hongjun's diagnosis is problematic, and he already has the courage to make the diagnosis. It's great!"

Sun Lien was a little embarrassed. When he just rejected Qian Hongjun's diagnosis, he didn't think about this. He just simply felt that Qian Hongjun's inferences and symptoms were not in line with the numbers.

"You pulled the pilot off the helicopter before to avoid a possible crash. The municipal party committee and government attached great importance to this, and they are planning to commend you." Liu Tangchun suddenly said, "I want to ask you, do you have any idea of ​​continuing to study in our college?"

Sun Lien was stunned, "But... I didn't register for this year's graduate exam..."

Liu Tangchun waved his hand and interrupted his speech, "If you want to do it, you will definitely let the college recommend it without the exam." He looked at Sun Lien and asked inadvertently, "If you can do it without the exam, do you want to go to the neurosurgery department to follow Liu Pingchuan, or come to me and be a fellow disciple with Zhou Jun?"
Chapter completed!
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