We have talked about fistulas before. Tracheal fistulas are fistulas that grow on the trachea at one end and connect to the trachea at the other end to form a special-shaped channel to another part of the human body. The most common one in adults is the pleura, which is a bronchopleural fistula. The cause of this disease is usually traced back to lung infections such as tuberculous empyema and lung abscess.
When the two teachers and doctors heard the student's doubts about the fistula diagnosis, they immediately looked back at the child.
The child's respiratory rate is OK, and he is not in a critical condition such as rapid suffocation. Wet rales mean there is infection but no high fever. If it is a lung abscess, he will have a high fever. The heart rate is around 120, not off the charts. This child's condition shows a certain weirdness everywhere. It seems that the child's condition is not very serious, and all vital signs are not in red alert. It is said that this child is not sick, but there are wet rales in the lungs. No wonder the two teachers were struggling to decide whether it was the residue of amniotic fluid after being accidentally inhaled into the lungs or choking on milk.
Bronchopleural fistula? Taking a photo might reveal the hidden fistula. Given Xie's excellent past performance, Dr. Peng again urged attention: "Take an X-ray."
"What she said may not be what you think." said Dr. Wang.
A neonatologist will definitely react faster than an obstetrician.
When his colleague said "No", Dr. Peng looked at Dr. Wang and the student for a while and suddenly realized: "The belly is big."
The teacher finally remembered that a group of people were standing here to study, and the main reason was that the child's father said that the child had a "big belly". The reason why the teachers forgot about it was that the symptom of the child's big belly was not obvious.
Xie Wanying was so persistent on this issue because she was familiar with the family of the child and knew the child's father, Hu Hao, better. Hu Hao's character was not very good, but he was a college graduate after all, his college entrance examination scores were not bad, and he had a good IQ, so the possibility of him making up such a story was very low.
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If the child's father is not sensitive, the child's symptom of a big belly may be established. What are the common causes of a child's big belly? Does abdominal distension mean that there is gas accumulation in the abdomen? If it is ascites, is it a congenital liver and gallbladder disease in the newborn? If it is not gas accumulation, if a lump is felt, is it a solid tumor in the abdomen?
Abdominal palpation is necessary. Dr. Wang's hands come again, pressing on the child's abdomen. The patient's condition is progressing. This time, Dr. Wang feels the symptoms of internal gas that Xie felt, and also notices that the child has a lot of saliva and is spitting.
"That's right." Doctor Wang said with a serious expression.
"Congenital." Dr. Peng followed his colleague's words with a long sigh in his tone.
The two of them argued for a long time about who was responsible for the accident due to misoperation, but it turned out to be the congenital disease that was to blame.
Congenital diseases in newborns account for 2-3% of all newborns, which is actually a high proportion. Generally, related symptoms will appear with the birth of the child. If the symptoms are very mild and difficult to identify, due to factors such as medical technology, it is possible that the child will not be discovered and diagnosed in time after birth, and the disease may be carried over to many years later or even cause death. This proportion is also high in clinical practice.
The families of the sick children may not understand these things.
Most of the families of sick children, upon hearing that their children were born with a disease, would anxiously question the doctor: Does this mean that the prenatal examination is a waste of effort?
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