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Dubai: 12-year-old diagnosed with rare condition after severe stomach pain; surgery saves life

The extremely rare bowel obstruction carries significant risk with mortality rates reaching as high as 40 per cent

Published: Tue 27 Aug 2024, 8:28 AM

Updated: Tue 27 Aug 2024, 10:47 PM

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When his 12-year-old daughter, Devna, complained of stomach pain earlier this month, Dubai resident Anoop thought it was a case of constipation. However, when the pain got so bad that she was unable to sleep, he knew that something was not right.

“She was crying in pain and was complaining she could not pass stool,” he said, speaking to Khaleej Times. “She was also vomiting. We took her to a nearby clinic, where the doctor asked us to rush her to the hospital.”

At Aster Hospital, Sharjah, laparoscopic specialist and general surgeon Dr Sandeep Tandel examined the child and noticed that she was unable to lie on the examining table. “She said that she was in excruciating pain, and I immediately knew that the problem was serious, so I sent her for a CT scan,” he said.

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Specialist Radiologist HOD, Dr Mohammed Ilyas was speechless when he saw the results. “I could not believe my eyes,” he said. “The child had a rare and potentially life-threatening condition called Cecal Volvulus, which causes the intestine to be completely twisted. In my 10-year career, I had never seen a child with this condition. I immediately called my fellow radiologist to confirm the images.”

The extremely rare bowel obstruction affects approximately 2.8 to 7.1 per million people annually and carries significant risk with mortality rates reaching as high as 40 per cent. “Time was of the essence,” said Dr. Sandeep. “If we waited too long, it could cause irreparable damage to the intestine. If the blood flow is cut for too long, then it would lead to that part of the intestine being 'dead'. We would have to remove that portion and reroute stool so that it can be removed through the child’s stomach. This could have significant impact on the child’s recovery and quality of life.”

Rushed into operation

Within 20 minutes of getting the CT scan, Devna was rushed into the operating room. “The entire hospital team worked together to make this happen,” said Dr Sandeep. “Elective surgeries were moved, lab results were given on a priority basis, and the operation theatre was readied urgently.”

The emergency surgery, which lasted approximately two hours and 40 minutes, involved untwisting the affected part of the intestine and fixing the cecum to the abdominal wall to prevent future occurrences of volvulus.

Even though the doctors were prepared for the worst, the timely intervention helped prevent serious complications. “The doctor had explained to us that there could be multiple stages to the operations and that stool might need to be drained from her stomach,” said Anoop. “However, by God’s grace we had caught the issue in time and the doctors’ quick action helped her recover quickly. On Monday, she went back to school. I am so thankful that she bounced back so fast.”

Divine intervention

Dr Mohammed said that he felt there was a divine intervention in Devna’s case. “When we were taking the CT scan, the child was in so much pain that she kept moving,” he said. “For an accurate scan, we need the patient to be completely still. When the image came back, only the place where the twisting had happened was clear. Above it and below it, the image was completely blurred because of the movement. It really felt like a miracle. Because the image was so clear, we didn’t have to waste time taking another CT scan.”

The condition involves the twisting of the cecum, leading to an obstruction that can cut off blood supply to the affected area, resulting in severe complications if not treated promptly. Symptoms often mimic other gastrointestinal issues, making early diagnosis challenging.

Like Dr Mohammed, Dr Sandeep had also never seen an instance of Cecal Volvulus in children during his career. “The condition itself is rare and I have only seen one patient with it during my time as a doctor,” he said. “However, in children it is absolutely unheard of. So, when I first saw Devna, this was not even on my checklist. It was due to the adequate support of the radiology department that we were able to diagnose it and act so quickly.”

He said this was also an important lesson to parents to not ignore severe pain in children. "When a condition doesn't improve in 24 hours, it requires medical attention," he said. "It should not be ignored."

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