He cried all the time and he never responded to our medical therapy. But he was eating food, no diarrhea, not vomiting, afebrile. Abdominal physical exam wasn't conclusive.
There is no CT scan or X-ray here... I finally took a chance this morning during my Pediatric rounds...
He was no better but no worse-- he just screamed off and on all night. I told the parents not to let him eat or drink anything and I put him on the surgery schedule. It had to be a surgical problem, right?
I didn't feel good telling his parents "we need to operate-- but I don't exactly know why."
I whispered a quick prayer as I induced anesthesia and we did a laparotomy. It turns out he had a big intussusception that we reduced before his bowel got ischemic.
His anesthesia & surgery went great. (Thanks Dr. Rollin Bland for the flawless surgery). Praying for this little boy'a recovery.
Chalk one up for the good guys
:-)
-Mason
(Anesthesia nerds: IV ketamine 0.5mg/kg then Halothane inhalation induction, Halothane maintenance, spontaneous respiration +/- manual ventilation assistance using Diamedica DPA02 draw over vaporizer). No neuromuscular blockade. Monitors: Precordial stethoscope and earpiece I bought in 1998, cheap $30 Pulse oximeter I bought off Amazon & a mostly malfunctioning automatic BP cuff. No EKG, no expired CO2 or gas analysis--Yep, it's possible)
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