The Enhanced Doctor-Chapter 377 Almost Misdiagnosed

After a little more casual chat, the child’s test results came in. The blood test was normal, the urine test was normal, but the CT scan was somewhat abnormal.

"Does this represent a mass in the peripheral visual area? We need to call in the neurologists, right? Do we need to do an MRI as well?" Liu Banxia asked after looking through the results.

Xu Hui nodded. "For now, we can only let neurosurgeons have a look. This is probably what’s causing the child’s peripheral vision loss. Let’s have them take a look first and see what they recommend."

"Doctor, is it a tumor?" the child’s mother asked anxiously.

"We can’t say for sure yet. We’re going to call for a consultation," Liu Banxia responded.

Zhang Xiao, who received the message, arrived quickly. After carefully looking at the CT scan, he said, "We should do an MRI. It will give us a clearer picture. But there’s a strong possibility it’s a craniopharyngioma. Are there any symptoms of diabetes insipidus or any other neurological symptoms?"

The child’s mother wiped away her tears and shook her head. "Nothing else, just headaches and fatigue."

"Let’s do an MRI. It seems it hasn’t affected the hypothalamic-pituitary function yet," Zhang Xiao advised.

"Brother Zhang, do we need to perform a lumbar puncture to measure the intracranial pressure?" Liu Banxia asked.

Zhang Xiao shook his head. "Let’s wait for the MRI results. Are there any other changes in the blood tests?"

Xu Hui nodded. "Currently, everything is normal. Perhaps it’s because the illness just started."

"That’s possible. Let’s proceed with the MRI. There aren’t many patients tonight, so you won’t have to queue," Zhang Xiao said.

The mother hurriedly nodded and led her child away for the MRI scan.

It was already after ten at night, but to confirm the child’s symptoms and to ease the child’s discomfort, everyone had to keep busy.

Headaches and toothaches are truly more troublesome than wound pain. That’s why people say a toothache isn’t a disease, but the pain can be unbearable.

The MRI results came out quickly, and they were consistent with the CT scan.

"We can basically confirm it’s a craniopharyngioma, which can only be removed through surgery," Zhang Xiao said after reviewing them.

"These types of tumors are mostly benign, and their removal won’t affect daily life. However, as the tumor grows, it will put pressure on the hypothalamus and pituitary gland, causing more symptoms."

"Craniopharyngiomas are typically congenital, though they are commonly detected in early childhood. The current symptoms are relatively mild, only affecting the optic nerve."

"It can only be treated through surgery. Should we admit him? Then I’ll see when the director or deputy director has time. Or would you prefer to go home and consider it first?"

The child’s mother had no idea what to do and looked at Liu Banxia.

"It’s true that surgery is the only way to remove the tumor. But since the child’s father isn’t here, you can discuss it with him. After all, it’s brain surgery," Liu Banxia said.

"We’ll also consult with neurosurgeons who specialize in this type of surgery and check their surgical schedules. In the meantime, there’s no other treatment, but you’ll need to take good care of him at home. His vision might be affected..."

"Banxia, wait a moment," Xu Hui suddenly interjected.

"Let me ask, has the child always been this thin? Or did this start in the last few years, or more recently?"

The child’s mother, who had been wiping her tears, paused for a moment. "He’s always been a bit thin. They said it’s because his stomach and intestines don’t absorb nutrients well. We bought many nutritional supplements, but they didn’t seem to help much."

Xu Hui frowned. "Do you think his current condition could be caused by an endocrine problem?"

"Unlikely," Zhang Xiao said. "If the endocrine system were affected, there would usually be symptoms of diabetes insipidus."

"But with a typical craniopharyngioma, the blood tests usually show some abnormalities, not be as normal as they are now. I’m wondering, could it be hypothyroidism? Hyperthyroidism is more common domestically, while hypothyroidism is rarer."

"Eh? Now that you mention it, these two conditions do have some similar symptoms. But because we saw the scans first, we immediately thought of craniopharyngioma," Zhang Xiao said, stroking his chin.

"Let’s do another thyroid function test then. We absolutely can’t get this wrong," Liu Banxia, who was listening nearby, added, sounding a bit apprehensive.

"Dr. Liu, does that mean it might not be a tumor?" the child’s mother asked, a glimmer of hope in her eyes.

"Let’s do the thyroid function tests first. I’ll call the lab and ask them to notify us the moment the results are out," Liu Banxia said reassuringly.

Despite the situation changing again, the child’s mother wasn’t annoyed. From what Liu Banxia and the others were implying, if it was a thyroid issue, he wouldn’t need brain surgery, and that was better than anything.

After they left, the three doctors looked at each other and exchanged wry smiles. Even though the test results weren’t out yet, they were all already leaning towards hypothyroidism.

This was because patients with craniopharyngioma rarely presented as underweight and small. If they had indeed misdiagnosed it as craniopharyngioma and performed surgery, the growth could be removed, but since the underlying cause wouldn’t be addressed, it would recur.

One manifestation of hypothyroidism is organ enlargement. If it truly was hypothyroidism, the overgrown tissue could be absorbed with medication, eliminating the need for surgery.

To put it mildly, this would have been a misdiagnosis. To put it bluntly, it would have been medical malpractice. Although it wouldn’t have directly cost the patient’s life, it would have caused the patient a lot of unnecessary suffering.

"Sigh... we nearly misdiagnosed," Liu Banxia said. "Live and learn, as they say. Brother Hui, I owe you a chicken drumstick tomorrow."

"I’m still feeling a bit uneasy now," Xu Hui said with a wry smile. "It shows how important standard procedures are. The CT scan results came out first, so we were predisposed to think it was a tumor."

Liu Banxia nodded. "If I hadn’t come over, it would have just been a routine examination. Actually, even without the scans as a reference, if we’d paid closer attention to the blood tests, we might have spotted some clues."

"You two don’t need to rush to admit fault," Zhang Xiao said. "I saw the blood test results too; it really wasn’t easy to notice. Plus, with the CT and MRI supporting that conclusion, who would have thought otherwise without noticing the patient’s build?"

"Let’s wait for the results. If it really is hypothyroidism, I’ll also get Xu Hui a chicken drumstick tomorrow. Tsk tsk, two chicken drumsticks. That’s a good meal right there."

This was purely banter. The chicken drumstick joke had been circulating in the Second Affiliated Hospital for so long that it was always a source of amusement whenever it came up. However, Xu Hui genuinely deserved praise. Otherwise, all three of them would have had to bear responsibility; none of them would have escaped it. 𝕗𝕣𝐞𝐞𝘄𝐞𝚋𝚗𝗼𝘃𝗲𝗹.𝚌𝕠𝚖

Sometimes, that’s just how it is; many diseases only have subtle differences.

Even Liu Banxia hadn’t noticed this time because he wasn’t very familiar with thyroid function and had also been predisposed to think the problem in the brain was a tumor.

Although this wasn’t a patient Liu Banxia was primarily responsible for, the situation still felt very intense. They had been discussing medical malpractice and doctor-patient relationships for a long time today, and now, it had nearly happened to them.

If they had unnecessarily performed a craniotomy on the child, would the consequences have been minor?

They waited and waited, and finally, the test results came out. They confirmed Xu Hui’s suspicion: it was indeed hypothyroidism.

DING! Diagnosis completed. You have earned 100 experience points and 50 proficiency points in Diagnostics.

Although the amount was pitifully small, Liu Banxia didn’t care in the slightest. He felt fortunate for himself and happy for the child. It was such a close call; the three of them were so relieved they could have hugged and jumped for joy.

The subsequent treatment was straightforward: admit the child to the hospital and start him on thyroid tablets or levothyroxine. He would be hospitalized for observation during this time to adjust his thyroid levels back to normal, after which he could continue taking medication at home.

The child was currently only showing early symptoms. If it progressed to the middle or late stages, there could be a risk of heart failure. However, once diagnosed, the condition is manageable.

The child’s mother didn’t mind the hospitalization request in the slightest. After all, taking medication and being under observation was a completely different concept from preparing for surgery.

Moreover, once the child’s thyroid function normalized, he might even have another growth spurt. And though he would need to take medication for life, that was hardly a significant burden.

"What were you all whispering about in there?" Wang Chao asked curiously when Liu Banxia and the others came out.

"We nearly made a misdiagnosis just now. Thankfully, Brother Hui had a flash of brilliance and figured it out," Liu Banxia said.

"Really? Even with three formidable doctors like you consulting together, something like that can still happen?" Wang Chao asked in surprise.

"This just goes to show that we must always remain vigilant," Liu Banxia said seriously. "We need to apply all our knowledge to make the most accurate diagnosis possible."

"I was originally planning to rest for a bit, but now I’m still a bit wound up. There aren’t many patients left. You guys find some time to rest; I’ll keep an eye on things."

"Do you think I can sleep?" Zhang Xiao said with a wry smile.

"Let’s talk a bit longer," Xu Hui added. "I feel like I’ve just survived a catastrophe."

"Was it really that intense?" Wang Chao asked, his curiosity piqued again.

The three of them glared at him in unison. Only those who’ve been through it can understand. It concerned their careers, after all. If they lost their jobs, their future would be uncertain.

A doctor’s job isn’t like others; a stain on their record is hard to wash away.

Even so, the three of them went upstairs to the ward to check on the child. This incident also served as a reminder: regardless of whether they knew the patient or not, during case discussions, they absolutely had to close the door to prevent any misunderstandings or negative impressions.

The outcome of today’s incident was good. But if they had encountered an ill-tempered patient who filed a complaint, a formal reprimand would have been unavoidable for the three of them.

And even if the hospital issued a penalty, they would have had to accept it without complaint. After all, they had indeed been negligent during the diagnostic process; it just hadn’t resulted in severe consequences.

Liu Banxia also used this incident as a negative example to teach the interns. These were all valuable lessons. After all, minimizing harm to the patient is paramount in medical treatment.

It’s common for children to be underweight and small, but this shouldn’t be dismissed. It must be considered in conjunction with other symptoms for a comprehensive judgment.