The patient, a slender middle-aged woman who’d had multiple operations and radiation for a cancer in her belly several years earlier, was struggling with nausea and vomiting again. Initially, the pattern was familiar: She would vomit every time she tried to eat. After a day or two, the problem, probably a kink in her intestines caused by residual scar tissue, would resolve on its own.
This time, however, the vomiting persisted. By the time she arrived at our hospital, she was so dehydrated that the skin on her face looked like fine crepe hanging from her brow and cheekbones.
Some of the doctors who heard her story were certain she needed an operation. That debilitating kink, they thought, could be snipped away in minutes by a surgeon’s skilled hand!
But her own surgeon held off. He explained that finding the precise band of scar causing her obstruction would be difficult and perhaps dangerous. With all the dense scarring from her previous operations and radiation, he wasn’t certain that he could find the offending kink, nor that his patient would necessarily benefit from surgery.
Instead, he gave her intravenous hydration and decompressed her intestines with a small tube threaded though her nose into her stomach. After a week, the woman was eating again and ready to go home.