socalfunplaces Chapter 673
Chapter 673
Let's take a look at it first,
Vomiting in children, approximate types of causes:
Digestive system: contains "improper feeding; Pharyngeal syndrome; esophageal atresia or esophageal tracheal fistula; Gastroesophageal reflux; achalasia; pyloric spasm or congenital pyloric obstruction; Gastric torsion; Gastric bleeding, intestinal atresia; Intestinal malrotation; ] atresia and stenosis; Hirschsprung disease; Ileus; intussusception..."
Each one taken out separately, it must be said for the first half of the day.
In addition to problems with the digestive tract,
And the brain.
Central vomiting: contains "intracranial infection; Increased intracranial pressure"
There are others:
Acute poisoning: suspicious history, poison analysis, neurological symptoms.
Circulatory system: early stage of acute myocardial infarction, heart failure scorpion
Urinary system...
Vestibular function (cerebral there) disorder vomiting: labyrinthitis, vertigo, nausea, vomiting, nystagmus; Meniere's disease:
Glaucoma: more common in angle-closure glaucoma, increased intraocular pressure through the trigeminal nerve reflex causes vomiting.
in a word
Very tedious!
Therefore, when encountering a child patient with this vomiting complaint, each doctor and department may give a different diagnosis.
These diagnoses are likely to be incurable.
It can only be ruled out again and again, and finally the final answer is found.
Therefore, do not blindly believe that a trip to the hospital can solve all problems, often a disease, to go through several times, dozens of diagnoses, months of repeated elimination, in order to finally find the cause.
At this time, the importance of an experienced doctor is shown.
......
Plug in, real cases of neighbors:
In April, the baby vomited, had eczema on his face, and then went to the dermatology department and gastroenterology. The first thing to go to is the dermatology, the dermatologist said that it is eczema, very typical, just apply the medicine. Then I went to the gastroenterology department, and the gastroenterology department gave different answers: it was the baby's allergy to milk and high protein, which led to vomiting, eczema (this time in line with 'monism'), and the treatment was to let the mother not eat beef, fish, cake... and so on these high-protein foods, in addition, babies can not drink ordinary milk powder, to drink deep hydrolyzed milk powder (about 3 times more expensive). ）
Saw two doctors,
The two doctors gave different answers.
So, who to believe?
That must be the doctor who believes in the second gastroenterology.
But the diagnosis of the second doctor gastroenterologist may not be correct, if after a period of treatment according to the doctor's advice, there is still no effect, then this "high-protein allergy" cause can be ruled out. You need to continue to register with your doctor to do other tests and look for other causes.
......
......
Back to the previous case "Vomiting baby who has not found the cause for a long time"
After the emergency doctor gave the diagnostic advice,
The next day,
The couple took the baby, and on the same day, ran three departments.
Pediatric gastroenterology: for vomiting,
Cardiology: Cardiac ultrasound for the history of "convulsions and cyanosis" shows "patent foramen ovale", so let the cardiology department evaluate the baby's "patent foramen ovale" whether it will affect the circulatory system and cause vomiting.
Neurology...
First of all, I went to the gastroenterology department.
After asking about the course of the condition, the gastroenterologist believes:
Frequent vomiting in the past half month, the possibility of infection is relatively large.
Therefore, it is recommended to take omeprazole for acid suppression.
However, the doctor also reminded young couples to beware of problems in the baby's digestive tract, and suggested that parents can try abdominal ultrasound and gastrointestinal angiography if they really can't find the cause.
The young couple finally decided not to do abdominal ultrasound and gastrointestinal angiography, but to see cardiology and neurology first.
subsequently
The gastroenterologist performed an individual examination and found new problems:
The anterior fontanelle is swollen and soft, and the bone suture is wide
From a gastroenterological point of view, this can be a bit of malnutrition.
Or a child, there is a little problem with development.
Gastroenterologist, it is recommended to do a CT to make a diagnosis.
However, CT has radiation after all, so the couple said that they would consider not doing it for the time being.
The husband and wife, holding the baby, came out of the gastroenterology,
Went to the cardiology department.
Specialists, more experienced than emergency physicians in their specialty.
(Off-topic: Emergency doctors have more experience in emergency rescue and have a wider range of knowledge.) Emergency departments and specialists have their own merits. ）
The specialist in cardiology, after seeing the "patent foramen ovale" of the cardiac ultrasound, directly concluded:
Vomiting has little to do with heart disease, patent foramen ovale, and can be re-examined at the age of 1.
The problem of patent foramen ovale, many babies will have, generally will grow slowly, don't worry...
Out of the cardiology department,
The interference of "patent foramen ovale" was excluded.
The husband and wife are slightly relieved that at least there is no problem with the heart, not a dangerous disease such as heart disease.
And then
The couple held the baby and came:
Pediatric neurology.
"Maybe a head CT..."
The doctor said directly.
To see nerves, doctors need to see them through CT.
The husband and wife: ".............................."
In the end, I still can't get around the CT thing!!
Helpless!
The husband and wife can only hold the baby and do CT!
......
The CT was queued and an appointment was made for CT as early as the next afternoon.
The next day, the couple took the baby who had vomited for one night and went for CT anxiously.
Radiation?
Don't think about it!
The vomiting was so bad that it frightened both husband and wife.
soon
Within an hour, the CT results came in.
The couple returned to the neurologist with the CT results.
Diagnosis:
Cranial CT did not reveal a specific nervous system that could cause vomiting, suspected of convulsions. Recommendation: Perform further cranial MRI.
Identification: Pit of the cranial fossa !!
Husband and wife: "........................
It feels like my mentality is about to collapse!!
CT is not enough?
Also do NMR ??
...
At this time, after tossing and turning several times, I failed to get results.
The road to medical treatment is too difficult!
Let the husband and wife be haggard!
At last
They thought of a person - Lin Feng!!
I heard that Dr. Lin Feng in the emergency department can be called a divine doctor, and he can do anything to eliminate the disease!
"Let's go, let's go to the emergency room!"
。
.