Naperville Sun HealthAware column:
Surgery saves boy with rare congenital band syndrome
July 9, 2012
Plainfield resident Nathaniel Alvarado, 10, was feeling fine when his parents Angelica and Ismael sent him off to school April 30. Little did they know their son had a ticking time bomb in his belly that could have cost him his life before the end of the week.
Soon after Nathaniel arrived at school, he developed a stomach ache and nausea. Everyone assumed he was suffering from an intestinal bug or digestive upset. But by 10:30, the pain was getting worse, and he was running a fever. The Alvarados took him to the Edward Plainfield Emergency Department.
Appendicitis was first suspected, but nothing definitive showed up in preliminary testing. Nathaniel was transferred for admission to the Pediatrics Unit at Edward Hospital in Naperville. Again, testing didn’t provide answers. Ultrasound and CT scans of his stomach all came up negative. But appendicitis still couldn’t be ruled out.
Thanks to an arrangement Edward has with the University of Chicago Medical Center, pediatric surgery is one of the services Edward offers as part of its comprehensive pediatric specialty care.
In Nathaniel’s case, this meant that Dr. Donald Liu, of the University of Chicago Pediatric Surgery group, was at Edward to examine him and to perform surgery, if needed. Liu noted the boy was lethargic, with belly pain coming in waves. Something didn’t seem right. He began to suspect an alternate diagnosis.
The Alvarados agreed to let Dr. Liu perform a minimally invasive surgical procedure called laparoscopy to see what was going on in Nathaniel’s tummy.
Once the Edward-based pediatric anesthesiologists had put Nathaniel to sleep, Liu made several small incisions in Nathaniel’s abdomen and inserted a slender tube-like instrument with a camera at one end into one of the openings. He found adhesions outside the boy’s intestines that formed a noose that was strangling his bowels.
The most common cause of these adhesions is surgery. But in Nathaniel’s case, he had never had surgery. Rather, he was born with these rare adhesions, known as congenital bands.
Liu noted the bowels were swelling and the tissue turning purple; Nathaniel was within six to eight hours of irreversible bowel damage and possibly lethal blood poisoning. Fortunately, the repair was quick and relatively simple.
Liu inserted surgical tools into another of the incisions, snipped the band and the intestine was released. Nathaniel went home less than 12 hours later.
“Within this same time period, Nathaniel could have died if nothing had been done,” Liu says.
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