Friday, July 06, 2007

fettuchini

surgeons are supposed to be tough. surgeons have seen some pretty wierd stuff, but occasionally you see something that really churns the stomach.

the patient came in after being involved in a car accident. he had an acute abdomen, but was otherwise stable. x-rays confirmed free air in the abdomen. easy call. the patient went to theater.

we opened the abdomen. it was full of intestinal content. not too surprising. and then...lying in this soup, free in the abdomen we found a meter long tape worm! i'm not embarrased to say i gagged. i threw it in a kidney dish where it entertained us with its peristaltic movements.

i found the perforation. it was mid small bowel. in the lumen i saw two more strands of fettuchini. i removed them. each was also about a meter long. (note at this point that in no way do i advocate surgery as treatment for tapeworm. i mean poor surgeons! that's just gross). soon all three worms were in the kidney dish writhing around merrily. they pretty much filled the entire dish.

the rest was easy. repaire, rinse, close up and go home.

but i have not felt comfortable about eating fettuchini since then.

19 comments:

Kenny said...

Oh god, I can only imagine what that must have been like.

rlbates said...

You may not get past this, but maybe you will. More than twenty years ago, as an intern in Gen Surg, I remember helping with a GSW to the abdomen. The young man had recently eaten red beans and rice (a delicious staple in Baton Rouge, LA). It took a while, but I enjoy that wonderful Cajun food again. Best to you.

Bongi said...

reminds me of another story. i'll post on it some time, but suffice to say, if you plan on committing suicide by shooting yourself through the stomach, thinking that is where the heart is, you should not full said organ with a hearty meal before the time. alcohol adds to the unpleasant smell too.

p.s. patient survived. she was pissed about that.

Jason said...

Sounds gross.... I think a roundworm infestation is worse because they are really fat and can fill up the small intestine.

Thanks for the suicide tip. I'll be sure to starve myself before shooting myself in the stomach. Then again, the stomach acids would really hurt wouldn't it? Hmmm...I'll probably drink a bottle or two of antacids then.

Bongi said...

sure jason. any time. and thank you for your pre suicide consideration for your surgeon.

the worst story was actually a friend of mine. he operated a child with an obstruction and secondary perforation due to a bezoar of ascaris worms. when he opened they started crawling out of the abdomen and up his arm and over the edge of the wound onto the drapes. he probably doesn't eat spaggetti.

Jason said...

Eeew...now that's something that will DEFINITELY put me off spaghetti.

Sid Schwab said...

Huh. I was getting ready to post about a time I was running the bowel after closing a couple of holes from a gsw, when I felt what I thought was a condom, or ballon: a round rubbery thing. "This guy must have been smuggling drugs," I announced to the crew. Then the thing moved. And like a sissy I yelled and dropped the bowel. It was ascaris. Scared me. I think I'll post about it anyway, sometime.

Bongi said...

so no spaggetti for you then either sid???

but seriously, the first time i felt an ascaris in the intestine, it felt like a nasogastric tube. i thought what the hell is that doing there. then i realised what it is ans screamed on the inside.

JaniceNW said...

Ascaris? Never heard of that one. We got to see a tapeworm(dead thank goodness) in Microbiology last year. They aren't too common in the US anymore.

Bongi said...

janice, still pretty common here

fitcat said...

Hi there - you left a comment on my post ages ago, well over a month. I've finally stopped being lazy and gotten to reading all my blogs and clicked on yours as well and I've enjoyed reading some of your posts - that is so gross about the tape worm though!! o.O

Toni Brayer MD said...

Just discovered your blog and it is great. I have a fascination with Africa and reading your experiences and musings is interesting and informative. I keep looking at that plate of fettuccine. I wrote a post on using maggots to debride wounds but somehow that doesn't really bother me. When you have time, check out my site: www.everythinghealth.net. Thanks TB

Bongi said...

thanks toni. interestingly enough i also have a fascination with africa.

also i was considering writing a small series on tough surgeons going weak at the knees. the second post was and may still be about those cute little grains of rice (maggotts)

Dizzy Dee said...

Wow. This is the most unique blog post I have EVER READ.

So do tapeworms really look like fettuccine.
And do you tell your patient this when he / she wakes up?

OMG. I think it can be rather embarrassing.

Which is why we all (young & old) need to take de-worming treatment medication!!! :P

dr. bean said...

Great story! i remember reading Viggo Olsen's account of operating on a patient with a bowel perf secondary to typhoid. He was having trouble finding the perf when to his relief he saw an ascaris wriggling through it.Greqat

Chrysalis Angel said...

I have just come across your blog, I hope you don't mind my dropping in. I must say you have a unique way of writing which gives the reader an extremely vivid picture as they go.
I am so very glad I changed my mind on the fettuccine tonight.

I have the utmost respect for the things surgeons do.

Kim said...

Thank you for the five pounds that I will now lose as I will not be eating anything for at least a week! LOL! : D

xmariachi said...

Nice post... I was just searching for fettuchini in google and I came here. I liked the post, and the blog itself.
Good lucK!

Jabulani said...

Hubby is a butcher so is mostly cool about any related gross stuff to chopping up meat carcasses. However, after he watched the film Hannibal and was frieked out by the scene where Hannibal is cutting into the guy's brain and frying it there and then, he pretty much struggles with anything cooked "at the table" now, including crepes!!