A young boy’s gastro symptoms lead to unexpected diagnosis

Looking back on the past few years of Nicholas’s life, his mom Stephanie still can’t quite believe what he was dealing with. “He’s now 10 years old, and from the time he was in kindergarten, he would often tell me that his tummy was hurting,” she says. “He’d have these recurring symptoms of cramps and vomiting, which would sometimes mean a trip to Emergency, but the results were never very conclusive. It always seemed like he was just dealing with a typical gastro like any other kid.”

Things took a turn for the worse though, when shortly after Christmas last year, Nicholas had a bout of vomiting more serious than anything he’d experienced before. The family’s trip to Emergency resulted in a clinic follow-up by their pediatrician, and then a consultation with Dr. Sherif Emil, head of Pediatric General and Thoracic Surgery at the Montreal Children’s Hospital. What Dr. Emil told them a few hours later came as a complete shock to the family.

An intestinal malformation

“Dr. Emil knew almost immediately what was wrong,” says Stephanie. He was suspicious of a condition called malrotation with volvulus, where the intestines are not properly fixed, and are twisted on their axis. The diagnosis was immediately confirmed with a special x-ray called an upper GI.  For Nicholas, the condition had existed since birth, and had gone undetected for many years. Within two days, Nicholas was in the operating room to have the problem corrected. Thankfully, his intestines had not suffered any damage.

Volvulus usually presents as an acute event, where the child starts to suddenly vomit bile and has to be operated emergently. Nicholas had the much less common presentation of chronic intermittent vomiting. During Nicholas’s surgery, Dr. Emil and the surgical team operated on his intestines to untangle them and leave them in a position that prevents them from twisting. “Nicholas was a trooper. Of course, he was pretty upset before going into the OR but he knew he had to do it to get better,” says Stephanie.

A successful recovery

Nicholas achieved his recovery milestones with ease. “The first day, the nurses just wanted him to sit up and he did it. The second day, he was out of bed and moving around. By the third day, he asked for a Timatin, which he had no trouble finishing!” says his mom with a laugh. Stephanie adds that their hospital stay was made better by many of the staff such as Megan, a nurse on the surgical unit. “I was really nervous for much of the ordeal and she helped me stay calm throughout.”

Nicholas is now back to a normal routine, and only comes to the Children’s every three months for follow-up. He’s very happy to be playing soccer again and not having to miss any school this year. “It’s a huge relief for him and for our whole family to have this behind us,” says Stephanie.