Today's surgery did not go as expected. It ended up taking more than 5 hours. On the good side, Lewis was stable throughout and is safely back in the NICU. We're too drained to go through all the details, here's a summary.
What they found
- the original g-tube site had deteriorated significantly more than anyone thought and all the original stitches had fallen apart.
- the pylorus, the valve at the bottom of the stomach, was thick and abnormal - they aren't sure why (it may have been that way from birth). A small part of the bottom part of his stomach was in terrible shape and 'not salvageable'
- the collection of fluid on Lewis' left side was not a hematoma, it was a very large abscess (infection) which was puss filled and stuck to the intestines in several places (surprising since he wasn't showing infection symptoms)
What they did
- cleaned up and closed the original g-tube site
- drained and cleaned out the abscess, detached the places where his intestines were stuck to the abscess and installed a drain (plastic tube that will be there temporarily) to keep the area clean
- removed the pylorus and a portion of the bottom part of the stomach and reattached the stomach to the intestine. Installed a drain which will help them monitor the healing of these stitches, which are in a very touchy spot.
-Lewis will most likely have another blood transfusion tonight to offset his blood loss from the surgery
The surgeon was not able to install a feeding tube of any type- there wasn't a safe solution given the other problems. In a week or so, after some healing and another barium survey, we will revisit using a naso-gastric tube to feed Lewis. In the meantime, he'll continue to be fed by IV. It will be several months before they can consider installing a g-tube again. No estimate on how much longer Lewis will be in the hospital, but we'll be focused on just getting him healed up for the next few weeks. Meantime, he is intubated and the nurses are working very hard to keep him comfortable.
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