galactorrhea
Introduction
Introduction to milk spill The most common nipple discharge is a pale yellow serous discharge, which occurs mostly in breast hyperplasia, intraductal papilloma, or breast cancer. Purulent nipple discharge is more common in breast inflammation and ductal dilatation. Bloody nipple discharge is common in intraductal papilloma or breast cancer. Of course, high prolactinosis caused by endocrine disorders can also lead to nipple galactorrhea. It is recommended to go to the hospital for detailed examination to confirm the diagnosis and timely treatment. basic knowledge The proportion of illness: 0.001% Susceptible people: more common in women Mode of infection: non-infectious Complications: amenorrhea, headache, nausea and vomiting, abdominal pain
Cause
Cause of galactorrhea
Tumor (30%):
In both sexes, prolactinoma is the most secreted tumor in the pituitary gland that produces too much PRL. In women, the majority of tumors are microadenomas (<10 mm in diameter), but a small number of large adenomas (>10 mm in diameter) are diagnosed. The incidence of microadenomas in men is very low, because most of them are found late.
Drugs (30%):
Hyperprolactinemia or galactorrhea can also be caused by taking certain drugs, including phenothiazine, some antihypertensive drugs (especially methyldopa) and opioids.
Primary hypothyroidism (20%)
Because of the increased TRH excitability of TSH and PRL secretion, hyperprolactinemia and galactorrhea can be produced. Hyperprolactinemia with low gonadotropin and hypogonadism is unclear.
Prevention
Milk spill prevention
Do a good job in breastfeeding after childbirth, breastfeeding time should not be too long, such as the emergence of abnormal milk secretion, should be promptly checked, exclude tumor factors, find out the cause, treat as soon as possible.
First, it is advisable to eat foods with anti-breast cancer effects, such as hippocampus, cockroach, cobra, sperm whale oil, clam meat, crab, red, clam, oyster, clam meat, kelp, asparagus, stone cauliflower.
Second, it is advisable to eat foods that enhance immunity and prevent recurrence, including mulberry, kiwi, asparagus, pumpkin, glutinous rice, kidney beans, yam, mushrooms, shrimp, crab, herring, prawns, and snakes.
Third, swelling should eat glutinous rice, loofah, red beans, medlar, grapes, lychee, medlar, carp, pond carp, carp, loach, stingray, snail.
Fourth, pain, nipple retraction should eat fennel, chopped green onion, shrimp, sea dragon, scented oil whale, orange cake, grapefruit, medlar.
5. Avoid smoking, alcohol, coffee, and cocoa.
Complication
Milk spill complication Complications amenorrhea headache nausea and vomiting abdominal pain
Often complicated by amenorrhea, caused by ovarian dysfunction.
Has been 18 years of age, menstruation has not yet come, or menstruation has been in the past six months without menstruation, or accompanied by headache, visual impairment, nausea, vomiting, periodic abdominal pain; or hairy, obese, galactorrhesis.
Symptom
Symptoms of chyrrhea Common symptoms Secondary amenorrhea, edema , menstruation, rare, Cushing's syndrome, pelvic mass, vulvar atrophy
Male or unbreasted women lactating.
Examine
Milk spill check
1, endocrine hormone determination: estrogen, prolactin, pituitary prolactin and so on.
2, imaging: X-ray lead target film, skull CT.
3. Cytological examination of the spill smear and CEA determination in the discharge.
4, B-ultrasound: B-ultrasound is a kind of ultrasound examination, is a non-surgical diagnostic examination, is an emerging discipline, has become an indispensable diagnostic method in modern clinical medicine.
Diagnosis
Separation diagnosis
diagnosis
The purpose of the first diagnosis is to prove the underlying hyperprolactinemia. In general, the level of basal PRL is related to tumor size and can be used as a basis for long-term patient follow-up. Hyperprolactinemia, low levels of serum gonadotropin and estrogen in women or in the normal range. In patients with normal TSH, primary hypothyroidism is easily ruled out. Although the lateral lateral view of the cone (single lateral coned-downview) can exclude large pituitary tumors, high-resolution CT and MRI are used to identify microadenomas. The preferred method. Any large adenoma disease that chooses medical treatment or follow-up should be examined visually.
Differential diagnosis
1, Greek-French syndrome: occurs more often in postpartum lactation, often has long-term galactorrhea after breastfeeding, accompanied by persistent amenorrhea.
2. Ade's syndrome: amenorrhea lactation syndrome caused by hypothalamic-pituitary dysfunction.
3, Fu-A syndrome: amenorrhea caused by pituitary tumors.
