During our first week in Migori after medical rounds I dropped by surgery with another student who is here (Peter) to see what was going on. It was Jodee’s week for surgery but she was kind enough to let me scrub in on an exploratory laparotomy. We don’t have access to CT scans here so the only way to know what was causing the peritonitis in this patient was to have a look inside.
Tools of the trade.
Ultimately the culprit turned out to be a ruptured appendix which we removed before checking the rest of the abdomen for pathology.
Ruptured Appendix
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| Me momentarily distracted by the camera. |
Jodee had already assisted in an amputation that morning. This patient lost his leg to gangrene. He waited too long to come in to the hospital, otherwise the amputation might have been below the knee or even avoided altogether.
After surgery I went by the lab again (outpatient clinic was not busy) and saw a positive Widal test. The Widal test is to check for typhoid (aka enteric fever).
This person had typhoid.
The next day Peter and I donated blood. I personally tested our blood. I checked hemoglobin, did blood typing, and checked for HIV, hepatitis B and C, and syphilis. Peter and I are both O- (universal donor). This means we can donate blood to anyone because our red blood cells have none of the major blood group (A, B or Rh factor) markers on their membranes for the other person’s immune system to recognize and attack. It also means someone who is O- can only receive O- blood because their immune systems will see the other blood groups as “foreign” and attack them.
Donating blood at our hospital is key. Recently a patient in his 20's died because they could find no blood for him.
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