What comes to mind when you see the word “intussusception”? If you are not at all medically inclined then you may not have even known that it was a thing, let alone how to pronounce it. For those of you who want to win at jeopardy it’s pronounced in·tus·sus·cep·tion. It is a condition whose cause is not well understood but it is always fatal if left untreated within 5 days of its occurrence. So what exactly is intussusception and why am I spending so much time talking about it?
To keep it simple, intussusception is the process by which part of the intestine telescopes within itself and usually occurs where the small intestine meets the colon or large intestine (see photo representation).
This leads to an intestinal obstruction, bowel death and eventual perforation of the intestines. It is the most common cause of intestinal obstruction in children 5 months to 3 years. Now that you are an expert on intussusception let me tell you about my 3 month old patient who came in the ER about 2 weeks ago around 10 pm…
The patient had a 2 day history of fever, vomiting and blood in his stools. He had been seen at a clinic near his home earlier that morning, about 9 hours from our hospital, where he was given fluids and his mother was told they needed to see a specialist. To this mother, whose father had neck surgery at our hospital some time ago, it made perfect sense that Hospital Loma de Luz would have the “specialists” her son needed to see. In case you were wondering, (and you may not have considered this since I threw a bunch of fancy terms and statistics at you to begin with) I am NOT a specialist in pediatrics.
I immediately radioed Alisa (cause I have learned that when you don’t know what to do you ask your wife) and ran the patient by her. It was clear from his distended abdomen and x-ray that this infant had an intestinal obstruction and now we had to determine why (although you can probably guess why if I have not completely lost you with my ramblings). Usually in the states this child would have had access to a variety of tests and tools to help quickly narrow down the diagnosis, to determine which specialist needed to be consulted and to determine the best approach for treatment. Here in Honduras we are deficient in our diagnostic testing with our most advanced imaging being x-ray.
Abdominal x-ray taken just after the patient arrived in our ER showing a belly full of air.
The doctor “on call” with me was none other than our General Surgeon, Dr. Alexander, who does not usually operate on children, let alone 3 month olds. We admitted the infant, gave him IV antibiotics and had a nasogastric tube placed to try to decompress his stomach but he continued to have fevers and more distention of his abdomen. We all had been praying for a miraculous healing but it was rapidly becoming apparent that we were losing the battle and needed to use more invasive measures. Having no experience in this type of pediatric abdominal surgery our general surgeon skyped with the pediatric surgeon back in the states to get his input and to get a crash course on what needed to happen with the surgery. Lacking onsite experience we were definitely at a disadvantage when it came to attempting surgical intervention.
During the operation we found that part of the small intestine had telescoped into the large intestine and Dr. Alexander worked to meticulously and delicately pull it back out. We could see evidence that the trapped bowel was beginning to show signs of dying and it would have only been a matter of hours before the damage would have been irreversible. By the grace of God this child made it through surgery without complications and one week after coming to our hospital he was discharged eating and pooping like a normal 3 month old should. Our medical staff worked diligently, trusting God to provide the strength and guidance we needed to give the best care possible despite our weaknesses. And just like the 5 loaves and 2 fish, God performed a miracle through our limited experiences and resources and all we can say is, to God be the glory!
When is the last time you boasted about your weaknesses? The word weakness can be more accurately defined by words like disadvantage, defect, deficiency, and imperfection. We all have weaknesses and yet we usually don’t go around broadcasting them to the rest of the world. Yet that is what the Apostle Paul encourages followers of Christ to do, to boast to the world about weaknesses. 2 Corinthins 12:9 says, “But he (God) said to me, “My grace is sufficient for you, for my power is made perfect in weakness.” Therefore I will boast all the more gladly about my weaknesses, so that Christ’s power may rest on me”. We have seen and testify to the power of Christ working in our weaknesses. The next time you and I encounter difficult circumstances I pray that we would be reminded of His sufficient grace!