In recent times, I have been too busy with too many patients to take stock, but a recent incident has given me the urge to write about it. The risky colonoscopy saved an old man from an open surgery, and the patient, whom every surgeon thought was cancerous, was ruled out after the risky colonoscopy, and now the old man tells everyone: “Zhu Song saved my life and pulled me back from the brink of death! It was 2 a.m. on March 25, and I was working the night shift at the hospital. The daughter of a good friend of my lover’s unit called and cried, “Sister-in-law, my father’s stomach pain is very strong, the doctor said that the MRI report in the afternoon is sigmoid colon occupancy, and now acute intestinal obstruction, peritonitis symptoms are very serious, to immediately operate, or once the intestine perforated full stomach stool, it must be rerouted.” I reassured her while asking about the medical history. The old man was 68 years old, usually in good health, but had thrombocytopenia. Recently, the urine is not smooth with fever, suspected prostatitis, is now living in Jinan Central Hospital urology treatment, can be continuously applied antibiotic treatment, still high fever does not subside, after dinner suddenly abdominal pain unbearable, abdominal distension gradually aggravated. Follow up the medical history, the patient has not exhausted for 5 days, now every urine that is anal discharge a little sticky yellow stool, 10-20 minutes once, sometimes a few minutes a trip, very urgent, tossed exhaustion. Now he has been fasting for a week and relying on nutritional support. After comforting the relatives, I suggested that the patient go for an abdominal plain film and wait until morning after I had finished my night shift to meet the patient in person before making a decision. By 3:00 a.m., another call came in saying that the abdominal plain film supported incomplete intestinal obstruction and that there was still a small gap in the intestinal cavity similar to a sweater pin. The doctor on duty at the central hospital saw that the family did not agree to emergency surgery and took the risk of giving an injection of dulcolax, saying that the abdominal pain was relieved. After 8:00 am, his daughter and I took the patient’s MRI and abdominal plain film, so that our chief of surgery, Qilu Hospital and Qianfo Mountain Hospital’s chief of surgery have looked at the film, all suggesting that surgery should be done quickly, and now do maybe just sigmoid colon segment resection anastomosis, no need to reroute; if the obstruction is aggravated again, the abdominal cavity is too polluted, we have to reroute, that is, artificial anus on the left side of the abdominal wall, and then change back after 3 months. The family was in a heavy mood, and I was also very nervous and regretful, afraid that the operation had been given a delay. We hurried to the central hospital ward, the doctor was preparing to transfer the patient from urology to general surgery, I gave the patient pressure on the abdomen, the symptoms of peritonitis is not too serious, and the director of surgery Liu together analyzed the condition. I felt that although the MRI reported sigmoid colon occupancy, no colonoscopy was done and no cancer was seen under direct vision, so I was a little undeterred. After consulting with Director Liu, I decided to take the risk of having a colonoscopy. Since the mass was 20cm away from the anal verge, I could go as deep as I could after entering the mirror, and if not, I could see the shape of the mass. As the colonoscopy of the central hospital could not be done that day, I consulted with Director Liu and decided to come to our hospital, I personally did it for him, anyway, ready for surgery, if the colonoscope appears perforated, it will be quickly pulled back by Director Liu responsible for surgery. Director Liu was very responsible and followed me to our provincial Chinese medicine colonoscopy room to view together. The patient was given 118 ml of sodium phosphate enema by the anus before entering the mirror, which should have been kept for 10 minutes for good effect, but the patient could not tolerate it, and after 3 minutes it was eliminated, and said that 2 farts were discharged, so I relaxed a little after listening to it, and I could exhaust it, which means that it was still passable. The patient injected gas into the intestinal cavity while entering the mirror, but the patient could not tolerate it, then exhausted, the intestinal cavity did not open, about 20 cm into the mirror after a lot of effort, risked forcing the mirror, the patient felt a heartburn, the mirror entered the intestinal cavity smoothly! After continuing to enter the mirror to the ileocecal region, the mirror was withdrawn for observation: a polyp with a tip 40 cm from the anal verge; a bulging mass 20 cm from the anal verge (accounting for half the circumference of the intestinal cavity, with an uneven surface), multiple diverticula, and intestinal inflammation, and the mass was sent for pathology. The pathological results showed mild atypical hyperplasia of colonic adenomatous adenoma. The polyps were later removed by colonoscopy and discharged. Immediately after colonoscopy that day, the patient’s abdominal distension was reduced and he felt hungry that evening. The patient later laughed and said he had never farted so much in his life, there were 300 of them. Reviewing the whole procedure, consider that this patient may have intestinal obstruction caused by intestinal torsion. The surgeon was reminded that although MRI and abdominal plain radiographs all suggested that the intestinal obstruction was caused by sigmoid colon occupancy and had obvious indications for intestinal obstruction surgery, it would be better to do a colonoscopy before surgery if possible and appropriate to further clarify the diagnosis (although there is a certain risk). In fact, I was very nervous and sweating when the colonoscope passed through the obstructed intestinal segment, and I would really fall to complain if it really perforated. Every doctor is well-intentioned, but the current medical environment makes us as doctors afraid to take risks. If this old man is not my acquaintance, if it is just an ordinary patient, if the real intestine perforation, I may eat lawsuits, out of medical disputes no one understands, no one to share for you, really is walking on thin ice! Appeal to the news media to report objectively, in fact, the doctor himself is the vulnerable individual. Once again lament the advantages and necessity of colonoscopy!!!