Indexing Title: DCHUA’s Medical Anecdotal Report [05-9]

MAR Title: A Medical Urban Legend

Date of Medical Observation: October 2005

Narration:

A newborn male was following up after cutback anoplasty for imperforate anus.  I was to dilate the anus to prevent scar strictures from narrowing the passage of feces later in his life.  I borrowed a set of urethral sound dilators and started with the smallest caliber.

Since the urologic dilators were rigid metal rods, I had to make sure under direct vision that the suture line was not disrupted/ traumatized in the process. With the patient’s scrotum hanging down, I used one hand to lift the obscuring sac while the other serially picked up larger and larger dilators.

As if in retaliation to the intrusion, the baby exploded.  What happens when the shit hits the fan?  I got drenched with brown liquid from hair, down to my eyes and face, down my shirt including documents in my pocket, down my pants and feet.

Insights: (Physical, Psychosocial, Ethical) (Discovery, Stimulus, Reinforcement)

While doing enemas or suctioning tracheostomies, medical personel are trained to stay away from the potential line of fire.  Other precautionary measures include the use to protective gear such as masks, gloves, and goggles.  If situations prevent such, one can always call for assistance.

My not anticipating liquid feces or not believing that such a small infant could generate such pressures or volume of feces led to an event I will never forget- a real live baby dynamite!