Pathology

There was a lot of pathology that passed through the hospital during our time in Bangladesh. We saw things we probably will never see in the US. It really helped to see some of these diseases first-hand, instead of only in a textbook. Here are some of the highlights:

This patient had severe rickets. We straightened his legs by essentially sawing wedges out of his tibia, fibula, and femur.

This child had tetanus which developed from a wound on his knee. He was so stiff that you could stick your hand under his head and lift his whole body like a board. In Bangladesh, only girls and pregnant women are immunized. This helps to cut down on neonatal tetanus, but obviously misses a large portion of the population. Fortunately, this patient walked out of the hospital.

We saw two patients who needed a gastrectomy in the same week! One of the patients had linitus plastica, a condition where the stomach is completely infiltrated with cancer. The other had chronic ulcerative disease which scarred the outlet from his stomach to the rest of his intestines to the size of a pinhole. As a result he had a huge stomach (pictured above)!

This young man had a necrotizing cancer of his shoulder. It was most likely a rhabdomyosarcoma. One of the trademarks of especially bad cancer, aside from the appearance, is an overwhelming smell of dead, rotting flesh. He had to be wheeled outside because of the smell.

Another grossly neglected cancer. This woman had what is known as a marjolin's ulcer. Essentially, it is a cancer that develops from a non-healing wound or ulcer. This woman came in with her foot covered in carbon in order to make the smell bearable. We had planned to do a below the knee amputation, but when she had her xray, we saw hundreds of gum-ball sized mets in her lungs - a terminal condition.

In my short stint in medicine, I had not seen any of this outside of a textbook. Seeing this amount of pathology in such an advanced state in real life was something that probably could not have been accomplished had we not come to Bangladesh. It was a great reinforcement of our medical education to see these conditions firsthand.