In the severe winter of Ulaanbaatar, the cold wind at minus 30 degrees takes snowflakes, hitting the glass windows of the hospital corridor. Ten-year-old Bolormaa huddled in a wheelchair, the cyan patch on her right knee having already spread into a fist-sized lump. Every movement felt like countless needles pricking—this was her eighth year of struggling with the "strange disease". No one had expected that this cyan mark, which appeared at birth, would leave this Mongolian girl's childhood fragmented in the rush of cross-border medical treatment. It was not until she met Director Shen Gang of Kyoto Children's Hospital that her fate finally took a turn for the better.
In the spring of 2015, when Bolormaa was born, there was a coin-sized cyan patch on the inner side of her right knee. The Mongolian doctor looked at it for a long time and only said, "It's a birthmark, it will fade on its own." But as Bolormaa learned to walk, the patch not only didn't fade but, like a balloon being inflated, gradually swelled into a soft lump that ached faintly when pressed.
Her parents rushed her to the best hospital in Ulaanbaatar. The doctor shook his head while holding the ultrasound report: "It might be a hemangioma, try this imported French medicine." That bottle of orange liquid became the family's hope. Bolormaa drank it on time every day, but the lump continued to grow wildly. In 2018, they scraped together money to fly to Paris. A renowned pediatric oncologist looked at the images and firmly said: "It's a complex hemangioma, increase the dosage."
She took the medicine for four years. The side effects made Bolormaa's cheeks swell like bread, but the swelling in her right lower limb worsened—the lump broke, oozing yellowish fluid, and the circumference of her leg was 12 centimeters thicker than her left leg. She could no longer run, or even tie her own shoelaces. The figure that once chased butterflies on the grassland was firmly trapped in a wheelchair. In 2022, a hospital in Seoul, South Korea, gave a more cruel conclusion: "Vascular malformation with bone damage, amputation may be necessary." Her mother hugged her daughter and cried until she collapsed, but Bolormaa wiped her mother's tears with her frostbitten little hands: "I'm not afraid, I just want to ride a horse again."
A turning point came at the 2023 International Pediatric Medical Forum. Bolormaa's father saw Chinese doctor Shen Gang explaining "Klippel-Trenaunay Syndrome" in a video, and the case pictures on the screen were surprisingly similar to his daughter's leg. He contacted someone overnight and learned that Director Shen Gang had joined Kyoto Children's Hospital, establishing a Hemangioma Interventional Therapy Department, specializing in tackling such difficult vascular diseases.
In June in Beijing, interpreters from the International Department of Kyoto Children's Hospital had long been waiting at the airport. When entering the consulting room, Bolormaa subconsciously hid her right leg to the side of the wheelchair, but was stopped by Shen Gang's gentle gaze: "Let uncle take a look, and we'll defeat it together, okay?" He wore a magnifying glass, checking the temperature and pulse of the lump inch by inch, and asked his assistant to bring up 17 imaging data from Mongolia, France, and South Korea, comparing them frame by frame.
"It's not a hemangioma, it's Klippel-Trenaunay Syndrome," Shen Gang pointed to the 3D vascular reconstruction image, his voice clear and firm. "You see, her veins are like a blocked river, while the arteries are trying their best to supply blood, which is why the swelling keeps getting worse. The previous medicine is not suitable; continuing to use it will make things worse." He picked up a model to demonstrate: "It's like the water pipes at home, the main valve isn't closed tightly, and the drain pipe is blocked. What we need to do is unclog the veins and then control the abnormal blood flow of the arteries."
These words stunned Bolormaa's parents—in eight years, they had heard the diagnosis of "hemangioma" countless times, and it was the first time someone had so clearly explained the cause. What made them even more at ease was that the hospital specially arranged a Mongolian interpreter, with seamless communication from examinations to treatment plan discussions, and even prepared Mongolian-style hand-grasped meat for meals.
The treatment plan was scheduled for the third day after admission: first, unclog the blocked veins through minimally invasive intervention, and then deal with the abnormally proliferated arteries two weeks later. Shen Gang's team specially brought in an ultra-fine catheter with a diameter of 0.8 millimeters—nearly half as thin as a conventional pediatric interventional catheter, which could accurately navigate through the delicate blood vessels of children.
On the day of the operation, Bolormaa, clutching a small woolen horse doll given by her mother, was wheeled into the operating room. Shen Gang said softly through his mask: "Take a nap, and when you wake up, you'll be able to race with the little horse." The anesthesiologist adjusted the dosage to ensure that this child, weighing only 22 kilograms, could not only fall asleep peacefully but also wake up quickly.
On the DSA angiography screen, the blood vessels in Bolormaa's right lower limb looked like a tangled mass of red threads. Shen Gang manipulated the catheter, gently inserting it from the femoral vein, "navigating" through the tortuous vascular maze. When the tip of the catheter reached the blocked area, he injected contrast agent, confirmed the position, and released a 3-millimeter-diameter balloon, gently expanding the narrow segment like inflating a deflated water pipe. Immediately after, a special biological glue flowed out along the catheter, accurately blocking the abnormal communicating branch—a mistake of even a tiny bit could damage normal blood vessels. Shen Gang's hands were steady as a rock, and the entire process took only 28 minutes.
In the second operation two weeks later, he embolized the overgrown small arteries with microcoils through arterial intervention. The day after the operation, Bolormaa tried to move her leg and suddenly exclaimed in surprise: "Mom, it doesn't hurt anymore!"
On the day of discharge, the yard of Kyoto Children's Hospital was full of roses in bloom. Bolormaa, wearing a new dress, carefully took steps, first walking slowly, then jogging. In the arc of her fluttering skirt, there was the freedom that had been lost and regained. Shen Gang measured the circumference of her leg with a tape measure: "It's 4 centimeters thinner than when you were admitted. Keep up with the rehabilitation training, and you'll be able to ride a horse on the grassland next year."
Before returning to their country, Bolormaa's father held a traditional Mongolian blue hada and insisted on tying it around Shen Gang's neck: "We took our child to four countries, spent all our savings, and it's you who made her stand up again." Shen Gang smiled and waved his hand, asking his assistant to translate the detailed rehabilitation plan into Mongolian, and put it into an envelope along with the QR code for remote follow-up: "Contact us anytime if you have any problems, our online clinic is available 24 hours a day."
Now, Bolormaa sends videos to the medical staff of Kyoto Children's Hospital every week—in the videos, she chases sheep on the grassland, and the scar on her right knee has faded into a faint thin line. This girl, once trapped in a wheelchair, will never know that her case has become a typical example in the diagnosis and treatment of international pediatric vascular malformations, and the internationalized diagnosis and treatment system of Kyoto Children's Hospital is allowing more and more cross-border patients like her to find the final answer in their cross-border medical journey.
As Shen Gang often says to his team: "What flows in children's blood vessels is not only blood but also the hope of a family. The more precise we are, the more promising the children's future will be."
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