Chapter 1009 The second brain in the body, the truth about encephalitis!

Hu Jingying lay down as she was told.

Xu Qiu performed visual, auditory, and percussion according to the procedure.

The order of abdominal examination and the conventional "visual, palpable, percussion, and auscultation" is not the same. In order to avoid irritation to the intestines and confusion of bowel sounds during percussion and palpation, auscultation is placed after visual examination.

During the examination, Xu Qiu really found some problems.

For example, when pressing the lower abdomen, Hu Jingying felt obvious discomfort.

Judging from the location and the degree of pain, it seems to be a common corpus luteum rupture in the emergency department, or acute torsion...

This made Xu Qiu a little puzzled. The other party must not have these acute and serious diseases, otherwise he would not be lying on the bed at this time.

But one thing that is clear is that this cannot be related to anti-NMDAR encephalitis... At least Xu Qiu has never heard that this disease can also cause abdominal pain.

"Is abdominal pain an independent disease?"

"Or are mental symptoms and abdominal pain complications?"

This is the problem that Xu Qiu needs to distinguish at the moment.

If it is the former, then there is nothing to say. Just do a routine examination package for abdominal pain, and it will be killed instantly.

But if it is the latter...

No matter how Xu Qiu thinks, it is difficult to directly connect the two.

In fact, there are many diseases that cause encephalopathy in the gastrointestinal tract, but there are few with symptoms similar to Hu Jingying. After careful identification, Xu Qiu denied them all.

At this moment, he suddenly thought of something and asked, "How are your bowel movements these days?"

Hu Jingying was stunned for a moment, thought about it for a few seconds, shook her head and said, "Not very good. I have been constipated recently... and I urinate a lot, often have to go many times, but only a little each time."

Constipation, frequent urination.

Xu Qiu quickly summarized the problem...If he added abdominal pain, he might really have a direction!

"Do an ultrasound... No, do a bedside ultrasound!" Xu Qiu couldn't wait.

Instead of sending it to the ultrasound department and waiting for the test report slowly, it is better to do it on the spot.

It's not a difficult operation anyway, and it doesn't require high-tech equipment. Xu Qiu can do it alone.

Not long after, the nurse came over with a bedside ultrasound machine.

After Xu Qiu applied the coupling agent, he scanned Hu Jingying's abdomen.

As the probe scanned the right appendage of Hu Jingying, a lesion with clear boundaries, no internal echoes, and posterior enhancement appeared on the screen.

The nurse who was observing the ultrasound results lit up and almost screamed.

Cystic solid lesions!

The patient's right appendage actually has a cyst!

"This is..." the nurse asked subconsciously.

Xu Qiu gave the answer: "Teratoma."

Hearing this, the nurse's pupils contracted... Teratoma? !

This is not a rare disease, and because of its special manifestations, it is a type of disease that most medical staff are familiar with.

Teratoma, which originates from germ cells, is the most common type of ovarian germ cell tumor.

Its manifestations are strange and varied. Simply put, it is like "a deformed embryo in development", so there may be skin, hair, teeth in the tumor, and some may even have structures similar to the fetal brain.

In theory, as long as the teratoma is large enough, it will squeeze the bladder and rectum to cause abdominal pain, frequent urination, and constipation.

However, being able to directly infer from abdominal pain, frequent urination, etc. that an ultrasound is needed, and then locking in the teratoma... This process is really too amazing.

I can only say that it is worthy of being Dr. Xu!

"Dr. Xu, what examinations will be arranged next?" She asked actively.

It seems that anti-NMDAR encephalitis and teratoma have to be treated at the same time, but I don't know if there will be any conflicts in the plan and drugs.

But Xu Qiu seemed to see through the nurse's thoughts and shook his head and said: "Next, just focus on the treatment of teratoma. Do a detailed ultrasound, and routine blood draw, chest X-ray, electrocardiogram..."

After that, Xu Qiu suddenly thought of something, turned his head to look at Hu Jingying, and asked: "Whether to have the operation or not, who do you plan to let sign?"

This is a tricky question.

Given Hu Jingying's condition, Bi Guang and Bi Guang's parents probably won't recognize this wife and daughter-in-law.

And Bi Guang's two brothers are not qualified to sign.

If you want to continue the treatment, you can only let Hu Jingying's relatives come over.

After a long silence, Hu Jingying seemed to have exhausted all her strength and said, "Doctor, I'll ask my mother to sign..."

...

In the afternoon, the discussion about Hu Jingying's ovarian teratoma treatment plan began.

At this time, two new cases were added to the patient's medical records.

One was a more detailed ultrasound examination report.

The ultrasound showed:

There were cystic solid lesions in Hu Jingying's right adnexa, with homogeneous and dense small light spots inside, part of which was filled with cystic cavities, which was a manifestation of fat filling.

Moreover, the boundaries and capsules of the teratoma could be clearly seen.

This was basically confirmed and had reached the surgical indicators.

And Xu Qiu also took this opportunity to explain the relationship between the so-called anti-NMDAR encephalitis and teratoma.

"Previously, the treatment according to the anti-NMDAR encephalitis plan was not effective.

The reason is that the cause of the mental symptoms is not encephalitis!"

As soon as these words came out, the conference room was silent.

The neurology department looked at each other in bewilderment. They were treating anti-NMDAR encephalitis, but it seemed to have no effect.

So the fundamental problem was not that the treatment was ineffective, but that the direction was wrong?

"Teratoma... So it was the teratoma that caused the pseudoencephalitis?" The deputy director of the Department of Neurology suddenly said.

But this made many people frown.

Even if the human immune system antagonizes tumors, how does it affect brain cells, and then how does it cause mental symptoms?

Could it be that ovarian teratoma can also cause mental disorders?

After a short discussion without any results, everyone turned their eyes to Xu Qiu.

Xu Qiu did not keep the suspense, and said lightly: "Because there is also brain tissue in the teratoma."

After that, he explained: "The immune system fights against substances in the teratoma, including antibodies against the brain tissue of the teratoma.

And these antibodies enter the blood and eventually enter the brain, attacking normal brain tissue indiscriminately!"

At this point, everyone finally reacted.

Although the manifestations in teratomas are varied, the probability of brain tissue appearing is still quite low...

The deputy director of the Department of Neurology quickly responded: "So the fundamental problem is that teratomas cause the body to attack brain tissue. To put it bluntly, it is similar to autoimmune diseases... The symptoms of encephalitis are actually the body's self-attack!"

Xu Qiu nodded lightly.

The others also suddenly realized, but there was still surprise on their faces... This conclusion was indeed somewhat unexpected.

After this discussion, Hu Jingying's disease was finally confirmed.

The next step is the surgical plan.

Due to Hu Jingying's special nature, this operation has bad news for her, but also good news that others do not have...