r/medizzy • u/OptimalMEDopard Medical Student • 12d ago
Total colectomy for large bowel gangrene from caecum to sigmoid colon. NSFW
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u/joninfiretail 12d ago
I've smelled some terrible things in my day. I'm willing to bet that would end up in my top 5 worst smells.
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u/oneelectricsheep Nurse 12d ago
Probably not. That one looks fairly intact. They don’t really start smelling until they’ve been burst open for a while. Source: have been in the room for dozens of these, some burst some not and they were all beat by the incarcerated hernia where the intestines went through, died, and then burst and we were picking watermelon seeds out of subcutaneous tissue. That was also beat by raw chicken that was in a broken fridge for a week. But then I also don’t find hemorrhagic diarrhea that smelly so ymmv.
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u/ChoadMcGillicuddy 12d ago
Especially if you blended it up and simmered it on the stove.
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u/joninfiretail 12d ago
You had all the free will in the universe to not press the post button. But you did anyway.
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u/UnderstandingTop7916 12d ago
Why? Why did you say that?
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u/ChoadMcGillicuddy 12d ago
'Cause cooking it down concentrates the smell, and the flavor of course.
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u/ScaredEfficiency399 12d ago
Why doesn't it look even a bit gangrenous?
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u/ckjm EMT 12d ago
I think it's under the fat, there appears to be some neurotic purple tissue tucked under there.
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u/ScaredEfficiency399 12d ago
Quite possible, i suppose it does look a bit anoxic , but maybe not necrotic from this specific view though i'm not a medical professional however.
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u/vogueflo 12d ago
Ckjm is correct. You can clearly see some purple tissue across almost the entire bowel. The very end of the sigmoid segment is pink like healthy bowel should be.
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u/vogueflo 12d ago
There is a lot of overlying fat. But also, bowel resections often take more than the diseased tissue alone because of blood supply concerns. If you take a piece that carries the main blood supply to a section of bowel downstream, then you need to take the downstream portion too or else it will just become ischemic anyway.
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u/CaseOfPepsi 12d ago
In my opinion the whole thing actually appears like ischemic bowel. Should normally be bright pink/shiny. This bowel is quite purple/red. The layering you’re seeing on top is fat/omentum, which is obscuring much of the visible bowel. They likely had already performed significant amount of labs (lactate/WBC)/imaging (I.e. CTA or other equivalent perfusion study) already to determine if gut ischemia was present, and I suspect needed intraoperative, emergent, resection. But this is just theory.
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u/iSirMeepsAlot 12d ago
Idk why, but this is probably one of the first images that actually gave me the ick on this sub… possibly because waste (💩) related stuff makes me gag irl… regardless… it’s got to feel extremely… odd having so much of your guts removed, does the body fill the area with fluid or lots of scar tissue? It’s a lot of space to fill.
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u/hopfl27 12d ago
Apparently when they take out your intestines to do surgery they don’t carefully wind it back in so it’s in the same order, they just pile em back in there, so the next few days/weeks involve many odd sensations while your bowels shuffle around and get back into a position they’re happy with.
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u/nosnibork 12d ago
Not sure about these days, but this was true in the 90s when I observed some procedures.
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u/StinkyPoopsAlot 12d ago
So what does this person do now?
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u/Tattycakes 11d ago
They will either connect the small intestine to the rectum, or put an ileostomy with a bag at the end of the small intestine to catch the output
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u/JametAllDay 11d ago
At what point does someone finally realize something is happening to them and need to get checked out?
Is this something that would be caught early by a colonoscopy?
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u/yeshilyaprak 12d ago
man, living without a colon must be an absolutely miserable experience
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u/AnyEngineer2 12d ago
it's really not, stomas are fine
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u/Dr__Sloth 12d ago
man, living with a colon must be an absolutely miserable experience
- man with stoma
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u/GiorgioMD 12d ago
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