Pediatric and Radiology Departments Shadowing at Hospital 108, Ha Noi

7/14-7/17/2014

During 7/14-7/17 at Hospital 108, we were placed with the Pediatric and Radiology Departments.  Because Hanoi has a high volume children hospital, the 108 military hospital does not receive many pediatric cases on a daily basis. However, we observed some urgent and more complicated cases including: a young girl with medulloblastoma and a unilateral medial gaze palsy, a child with nephrotic syndrome presenting with ascites, and several pneumonia cases varying in severity–some even requiring mechanical ventilation.

It was difficult seeing younger children suffer, and we could tell how anxious all of their parents were. We came to appreciate the importance of comforting and communicating with these childrens’ families, especially in a culture that places a strong emphasis on their future generations over themselves.

With the radiology department, we were able to observe different pathologies using CT, MRI, as well as ultrasound. In fact, Hospital 108 has a dedicated ultrasound department with radiologists that specialize in performing and diagnosing with ultrasound. The most prevalent diagnoses we observed with US were: kidney stones, stones found in ureter constriction sites, gallstones, thyroid cysts and nodules, carcinoma of the thyroid, hepatocellular carcinoma, and uterine and cervical cysts. With ultrasound guidance, we also observed OB ultrasound that examined the BP diameter, femur length, and cardiac Doppler of fetuses. It was also refreshing to see patients who were very excited for their doctor visits.

From 9am to 12pm, a large waiting room filled with patients were scanned and diagnosed by five ultrasound radiologists, as we were left very impressed with their efficiency and attention to detail in their work.

With the CT and MRI radiologists, we gathered in front of the computer and went through images of interesting pathologies that include a descending aorta dissection, spinal AV fistula, carcinoma of the cystic duct, intestinal obstructions from colon tumor vs. infection…etc.  In addition, we were introduced to advanced imaging techniques/procedures including virtual endoscopy of the large bowel using gas insufflation followed by 3D reconstruction of CT slides, and lung needle biopsies with CT guidance.

Overall, we learned a great deal about patient care, different pathologies, and new medical diagnostic technologies from this short experience.  What impressed us the most, however, were the doctors’ efforts in ensuring that we had a fulfilling learning experience. We really appreciated their patience in trying to communicate with us in English, as well as their taking time to show us their specialties.

Our last lunch with doctors of the radiology department: Bac Si Lam Khanh (director), Bac Si Diep, Bac Si Hang, Bac Si Chi and Bac Si Dung

Our last lunch with doctors of the radiology department: Bac Si Lam Khanh (director), Bac Si Diep, Bac Si Hang, Bac Si Chi and Bac Si Dung

– Mark Lin

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