After raising a cat, the goddess doctor became popular in the interstellar

Chapter 287
"Why not a thyroglossal duct cyst?" Nie Yuan thought for a while, then asked again: "This is the most likely clinical misdiagnosis."

"Indeed, thyroglossal duct cyst is similar to the symptoms of ectopic thyroid no matter its location or the painless sensation when touched." Tao Le said with a confident light on his face:

"But Mr. Nie, don't try to mislead me. Thyroglossal duct cyst is a congenital disease caused by incomplete degeneration of the thyroglossal duct. It is easy to cause infection, but it has nothing to do with hypothyroidism."

If just now, Nie Yuan's question was still in the nature of an exam, now he has already developed a sense of competitiveness.

He majored in children's endocrinology, and worked in clinic for many years, which is how he has today's clinical intuition.

But how old is this little girl, how can she do both Chinese and Western medicine, and in this endocrinology subject, she has such a strong ability to combine theory with practice?

Naturally, he couldn't guess that just last weekend, Tao Le's understanding of children's endocrine was only general.

But from Monday to Friday, four nights have passed.With her current superhuman memory and comprehension, she has already supplemented all the relevant knowledge and documents. If she just speaks, even he herself may not be able to match it.

"Last question." Nie Yuan asked: "Assuming that the child just now is really an ectopic thyroid, then this kind of congenital disease should be present at birth, right? Why did the lump develop only recently?"

Tao Le didn't even bother to answer this time, and only said three words, which made Nie Yuan shut up resentfully.

These three words are: puberty.

Most cervical ectopic thyroid glands are located on the submental thyroid hyoid bone. There are generally no clinical symptoms in early childhood, and most of them only enlarge in adolescence before being discovered.

In Nie Yuan's heart, he was actually a little sad.

When he was asked this question by his tutor, he was speechless and answered irrelevantly, and was severely criticized.

Speaking of which, he was studying for a master's degree at that time, and he was a year older than the little Tao in front of him.

He closed his mouth, and repeated the number with a sullen head.

What's the matter with this patient, I called him early tomorrow, why didn't he come in all the time, so as to save Dr. Ben?
At around three o'clock in the afternoon, the grandparents and grandchildren came back.

Nie Yuan flipped through the inspection results one by one, and then handed them to Tao Le one by one.

The results of the thyroid function test are the same as before, there is nothing to say, the hypothyroidism is still the same.

MRI of the pituitary gland showed plumpness of the pituitary gland, and the peak of the growth hormone challenge test was basically normal—this ruled out short stature due to growth hormone deficiency.

The color Doppler ultrasound results of the superficial tumor showed that there were solid nodules in the muscular tissue layer of the anterior neck area, and the blood flow signal was rich—this meant that the mass was likely to be the thyroid in the wrong place.

But there are several types of ectopic thyroid.The first type is that there is a thyroid gland in the orthotopic position, and another one grows in another place; the second type is the ectopic thyroid gland itself, which is the extension of the orthotopic thyroid gland; and the third type is completely ectopic, that is, only the ectopic thyroid gland .

The results of static ECT of the thyroid showed that there was no growth of thyroid on both sides of the trachea of ​​the child at all; while nodules with thickened distribution of imaging agents were seen at the base of the tongue, which was considered to be ectopic thyroid tissue.

This proves that the lump that Xiao Meixin gave birth to was a completely ectopic thyroid gland.

About 30.00% of patients with ectopic thyroid will have symptoms of hypothyroidism.

So this is why static ECT has to be done.

If it is the ectopic thyroid gland in the first two cases, the excess ectopic thyroid gland can be removed surgically; but if the patient has only one ectopic thyroid gland and it is removed hastily during the operation—that is an iatrogenic accident.

There were a lot of inspection reports, and Nie Yuan and Tao Lechuan didn't take too long to read them.

During this time, the grandmother was obviously restless.

Of course, she had read all the results just now.

Even though she didn't quite understand it, she also saw that there was blood flow inside the mass as mentioned in the color Doppler ultrasound results.

There is blood flow in the lump, so it cannot be a good thing.She had already learned this kind of common sense in the popular science exchange of the neighbor's aunt.

So right now, she was really worried.

It's just that the various inspections just done add up to close to 2000 yuan.

And that's just a pre-check.I don't know how much it will cost if I have another operation, hospitalization, and post-medication maintenance.

By the way, maybe there is radiotherapy and chemotherapy.

She and her husband have retirement pensions totaling more than 4000 a month, and they live in Yunshi with enough food and clothing.

I really didn't expect that this child could have such a serious illness.

But no matter what, Meixin was raised by her own family, so no matter how much it costs, she has to be treated.

The family still has more than 20 yuan in savings, which was originally used by the old couple for retirement, so this time they have to take it all out.

By the way, I have to tell my daughter quickly so that her husband and wife can also raise money.

In such a short time, countless thoughts have turned in her mind.

"Doctor, look at this thing, at what stage has it progressed, does it need to be operated on immediately?" She asked tremblingly.

Nie Yuan looked up at her and replied, "There is no need for surgery for this disease."

Isn't it unnecessary? If the only thyroid gland is cut off by others, how can it work?

Unexpectedly, such a simple sentence caused grandma's heart to be turned upside down again.

What do you mean by this doctor?It can't be what I thought, even the chance of surgery is gone, right?
Just now I was worried about spending too much money, but now I am afraid that I will not be able to do it.Xiao Meixin is so young, she shouldn't have no chance.

It's all my own fault, I didn't take it seriously before, if only I brought her to the first hospital earlier
In a few seconds, grandma's eye circles turned red, and tears filled her eyes.

When Tao Le saw it, he was startled immediately.

"Auntie, don't get me wrong. Director Nie is saying that this disease is not serious, and there is no need for surgery at all. It can be improved with some medicine."

Nie Yuan nodded helplessly.He didn't expect that the brain circuit of the aunt in front of him had already transferred to the advanced stage of tumor.

"Not serious?" Grandma stood blankly, and then glanced at her granddaughter again.

Since the results of the examination came out, the little girl Meixin saw her grandma's serious face, and felt very uneasy.

Now that she heard the doctor say it was not serious, she let out a tightly held breath.

"The child has congenital hypothyroidism. The reason is ectopic thyroid gland." Nie Yuan said in his deep and credible voice, "This is why the child is shorter than children of the same age."

Grandma doesn't know much about endocrine.She was obsessed with the lump: "Then, don't you need to cut this lump?"

"That's the child's thyroid gland. It can't be cut." Nie Yuan said, "I'll prescribe some medicine and take it for a while. It may shrink by itself."

He ordered a prescription, Tao Le typed it out, and handed it to grandma.

"Come back in three weeks for a reexamination of the armor. The lump, when it grows up, if it doesn't shrink and affect the appearance, you can choose to transplant it elsewhere." Nie Yuan instructed.

Grandma looked at the list in her hand, and there was only one medicine, and she took one tablet every morning.

"It's so simple? You don't need to be hospitalized, and you don't need to take a bottle, just take some medicine?" Grandma couldn't believe it.

The previous set of inspections was as fierce as a tiger, but when it came to treatment, it was drizzle.She felt that all the energy she had held back for so long was in vain.

Tao Le showed a big smile: "Yes, as long as the previous inspection is in place and the diagnosis is correct, sometimes the treatment is as simple as that."

"Ah, okay, thank you doctor!" Grandma happily led Xiao Meixin, and went out to pay the fee.

"27 yuan anise."

"so cheap?"

Indeed, this kind of levothyroxine sodium tablets is really not expensive, and a box of [-] tablets can last for a long time.

(End of this chapter)