Recently, I am about to finish my rotation in the respiratory department. Before finishing, I followed a full day of surgeries, intensely absorbing knowledge related to bronchoscopy. I encountered several impressive cases and would like to share them.
HPV Infection in the Respiratory Tract
The patient is a middle-aged woman with HPV infection in the respiratory tract. Large clusters of papillomas can be seen on the vocal cords (I won’t show them as they’re too graphic), and the main bronchus is also affected. The symptoms naturally include airway stenosis causing impaired ventilation, and the fragile papillomas are prone to rupture, leading to hemoptysis.
As for treatment, the surgical approach involves cutting them off and cryotherapy. I’m not very familiar with the medical treatment part, so contributions are welcome.
https://mp.weixin.qq.com/s/lg5JhYTvMrsePMClAJrTag
The biggest insight from this case wasn’t so much what I learned, but the importance of taking HPV seriously. In the past, HPV was only associated with cervical cancer, but it can also infect the respiratory tract. So, if you can get vaccinated, you definitely should 
Tracheoesophageal Fistula
Another impressive case was a tracheoesophageal fistula. After the esophagus and airway become connected, food debris continuously enters the respiratory tract through the fistula, causing infections.
The biggest insight from this case is how digestive fluids can burn through tissue to create such a black hole—no wonder mammals are said to have the “strongest digestive system.”
It also reminded me of when I saw brownish-black gastric juice being suctioned out under negative pressure in the gastroenterology department, but unfortunately, no pictures were taken at that time.
If I get the chance later, I want to observe a gastroscopy again. If the gastric juice can burn other areas like this, what must it look like inside the stomach?
More
Everyone should try to observe surgeries from various specialties whenever possible. The views under the scope, imaging, and atlases are all different. Watching videos and participating in person are also different experiences. Observing from the side is different from assisting by holding the scope.
I won’t go into more detail—it’s too tough.