Patient's question:
Inspection and Examination:1. Head CT scan on November 16, 2012: The results showed reduced white matter in both cerebral hemispheres, no abnormal signals in the cerebral parenchyma, no abnormal morphology or signal in the brainstem and cerebellum, no ventricular system dilation, no abnormal changes in sulci and fissures, and central alignment of midline structures.
2. Color Doppler on November 13, 2012: The maximum of the right liver was 7.5 cm, the anteroposterior diameter of the left liver was 3.5 cm, and the vertical diameter was 4.2 cm. The liver surface was smooth, the edges were regular, and the liver showed fine, slightly granular echoes, evenly distributed. The caudate lobe size and internal echoes were normal. The main portal vein diameter was 0.6 cm, with portal venous flow velocity of 16.3 cm/s. The superior mesenteric vein diameter was 0.4 cm, with flow velocity of 15.2 cm/s. The hepatic veins were not markedly dilated, and no significant abnormal echoes were observed in the lumen. The common bile duct diameter was 0.3 cm, with no abnormal echoes, and no significant dilation of intrahepatic bile ducts. The pancreas size and shape were normal, with a smooth surface and uniform internal echoes. The main pancreatic duct diameter was not markedly dilated. The spleen thickness was 1.5 cm, not palpable below the left ribs, with uniform internal echoes. The splenic vein diameter was 0.4 cm, with flow velocity of 15.0 cm/s.
3. White blood cell count: 9,800. Neutrophil percentage: 36.40. Lymphocyte percentage: 60.30. Monocyte percentage: 1.00. Eosinophil percentage: 0.80. Basophil percentage: 1.50. Neutrophil count: 3.57. Lymphocyte count: 5.91. Monocyte count: 0.10. Eosinophil count: 0.08. Basophil count: 0.14. Red blood cell count: 3.94. Hemoglobin: 130. Mean corpuscular volume: 99.20. Hematocrit: 0.391. Mean corpuscular hemoglobin: 33.0. Mean corpuscular hemoglobin concentration: 333.0. Red blood cell volume distribution width (SD): 74.70. Red blood cell volume distribution width (CV): 17.5. Platelet count: 578. Platelet volume fraction: 0.44. Mean platelet volume: 7.6. Platelet volume distribution width: 16.1.
4. On November 16, 2012: Thyroid-stimulating hormone: 2.580. Free thyroxine: 15.70. Free triiodothyronine: 4.76.
5. Blood and urine samples were sent to Shanghai for genetic metabolic disease screening. The first blood test results showed very long chain acyl-CoA dehydrogenase deficiency, while the urine test results were not indicative of a genetic metabolic disease. Subsequent blood tests later ruled out genetic metabolic disease.
Doctor's answer:
This requires seeing the child, combined with medical history and physical examination to have a direction.