Thursday, April 14, 2011

SDMC Hospital Attachment Day 3

Day 3: Endoscopy - A journey through gastrointestinal track

Today is rather interesting compared to the last 2 days. We went to endoscopy department!!! Specifically, colonoscopy. What they do over here is basically just poke a endoscope into your digestive track either through your mouth, or from your anus. :) Ok, this just sounds really weird.

The endoscope is like a camera on a long soft tube, with light, can be controlled by remote control, have suction pump...that's about it from what i observed. (This is definitely not accurate, please google it if you are interested to know more.) So it started by giving sedatives to the patient, fitting a plastic thingy onto his/her mouth to keep it opened and put the endoscope in. It's very interesting actually, like you are actually travelling into the person's stomach. (And i realise how long our tongue is). If you enter through the mouth, first you'll pass through the oesophagus, then the stomach. If through anus, colon then small intestine. (Dont worry about seeing faeces, cause the patients fasted before doing endoscopy, so it's rather clean inside)

Cases...
1. An old woman with oesophagus reflux - narrowing of oesophagus. It may be due to inflammation or external pressure. Will cause food to be stuck there... Through the endoscope, the epithelial wall seems perfectly fine, so they suspect it could be due to expansion of lung or something. They did dilate it afterwards and did biopsy test to check if the hypothesis is true.

2. A mid-age man with inflammed oesophagus. The sight of it is rather disgusting. (sorry to say that) The wall is full of ulcers!! O.o With puss. The symptoms are feeling of chest burning and non-stop hiccuping. Same procedure, took samples of tissues and did biopsy test, wait for the result. though i find the way they use a wire with small clip (something like crocodile clip) in front to take samples are very "cute".

3. Ulcers in colon. This, we have to enter through the butt. It looks rather painful, i mean the way the endoscope was pushed into the anus. The ulcers are causing gastrointestinal bleeding...same procedure, but this time, the doctor did push the endoscope till it reach the small intestine. We saw the villi!!! :) Villi are actually very pretty...hahaha.... Studied this thing since secondary school and today, i finally get to see how it really looks like.

4. Food stuck in stomach. The doctor also dont know what happened to this guy. This patient, although being questioned again and again, claimed that he fasted. But it was very suspicious. Because there's no obstruction along the track, but the food is there. You know how gruesome that sight is?! It looks like..."rubbish" or some rotten stuff. Mash of blue, black, yellow stuff inside. It's very very shocking especially when you expect nothing and keep poking the camera in until when you enter the stomach, this scary huge mass of monster appear in front of you. The doctor actually mumbled some rude words and shouted YUCK when he found that.... Dont laugh, trust me, it's really very disgusting. So, the doctor can't continue with what he was supposed to do... blah...

5. Other cases...can't remember/can't understand.... only know they took samples for each of them to be tested.

Other random stuff I had learned today:
Helicobacter pylori is the microorganism that attacks the mucous layer of the digestive track.
Digestive track is covered by thick layer of mucous, (though i knew before this) IT LOOKED SHINNY. :D
A reminder for the future me (in case i succeeded in graduating from med school): DO NOT LOSE YOUR SENSE OF HUMOR!!!! A doctor who is very kind, friendly and caring seriously does make a difference when compared to an EXTREMELY serious and strict doctor. Yea, of course you have to be serious in your work but remember to smile at the same time. Dont make life miserable for the people around you. Dont simply scold nurses, they too work very hard.
Gastroesophagus reflux - backflow of gastric juice

That's about it..I missed the afternoon session, diagnosis. Went to EUCLID maths competition. Finally realise, I SUCK AT MATHS. :p

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