Interesting Cases

3 February 2017


This little boy was brought into the Chiminisijuan clinic (up in the mountain) by his mother and grandmother because they “saw five worms come out of his mouth yesterday.” That's not very unusual for this area, but while I was listening to his lungs, I found this interesting congenital mole. They said he was born with it. Nothing too exciting but it looks kind of cool.


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This lady came to the clinic in Canillá because she had this itchy spot on her face for a couple of years. It didn’t get better with any cream. With that story and its appearance, it almost certainly was a basal cell carcinoma. This is a common form of skin cancer that rarely metastasizes but can cause significant skin ulcers that spread locally.


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In this location, I wasn’t too excited to remove it, but one of the other doctors was willing to do it.


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She came back a week later to have the stitches removed. She was told to keep an eye on it for any recurrence.


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One morning on our day off, I was about to sit down to a breakfast of Huevos a la Mexicana (Mexican Eggs) prepared by none other than Areli my Mexican wife, when one of the missionaries came rushing in on the four wheeler. He said that a man had fallen into the small canal that is alongside many of the streets of Canillá and was bleeding profusely from his right arm. I rushed to the hospital in the Dusty Chevrolet dressed in sandals and shorts. Jacob, a visiting EMT student was holding pressure through a blood-soaked dressing.


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It was a 91-year-old man who had somehow managed to slice open the back of his right hand. We suspect that he may have fallen onto his machete or possibly cut his hand on a sharp part of the canal. It was quite suspicious that he had cut through at least two tendons as he wasn’t able to straighten his last two fingers. It is also possible that he had a wrist or hand fracture. After a long discussion with various family members explaining that he really need to see a hand surgeon to repair the tendons, they decided to just have me sew up his hand and hope for the best. They didn’t have the resources to travel all the way to Guatemala City to find a hand surgeon that would charge a lot of money to fix this problem in a 91-year-old man.

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