Caroline Anderson - One Night, One Unexpected Miracle

‘No. It was nothing you did. There’s no evidence to suggest anything of the sort. What happens is that the cells that become the gut migrate up into the umbilical cord at about ten weeks of pregnancy, and then at around eleven weeks they migrate back down again, and coil into the area that becomes the abdomen. And sometimes, about once in every five hundred babies, they coil the wrong way, because our bodies aren’t symmetrical inside.

‘The liver is on the right, the spleen and pancreas and stomach on the left, and the small intestine starts at the bottom of the stomach and curls around past the liver, picking up the bile and pancreatic ducts, and then this great tangle of small intestine wriggles around inside and joins the large bowel down on the right, where we get appendicitis.

‘In children with malrotation it coils the other way, so that join in the gut can end up near their stomach or even on the other side, so diagnosing appendicitis is difficult, and that’s often when asymptomatic malrotation is diagnosed.

‘The problem arises when the part that is trying to be the right way round gets twisted somehow in a bit of a conflict of interests with the other bit, and that twisting process can lead to what’s known as a volvulus, which means the blood supply to that part is kinked and cut off by the twisting, and that’s a life-threatening emergency.

‘Daisy is not at that stage, but she may be approaching it, because she could have bands of fibrous tissue called Ladd’s bands holding her intestines in the wrong place. That’s what our tests today are going to look for, to find out exactly how her gut is coiled inside her, and where the pinch points or twists might lie so we can rearrange her gut to relieve that, if it’s what’s causing her pain. Does that make sense?’

They nodded, but she noticed they didn’t offer each other any support or interact in any way, which seemed odd.

‘Is there anything else we can tell you before we admit her and she goes down for her scan?’

They shook their heads, again not conferring.

‘OK, that’s good. Feel free to ask, though, at any time, because I know it’s a lot to take in. So, Dr Marco, what’s the verdict?’ she asked lightly, turning to face the examination couch again. ‘Do Daisy and Wuzzle need to have some pictures taken?’

He turned his head and smiled. ‘Yes, I think they do. I think we need to find out why they’ve got tummy ache. So, Dr Alice, how are we going to take the pictures?’

‘Well, Daisy, after you’ve been checked in by a nurse we’ll take you downstairs, and a lady there will give you a special drink, and then we’ll take pictures of the drink all through the morning as it moves through your tummy. It’s called a follow-through contrast scan, and it’s very good at showing us where things aren’t working quite like they should be. Is that OK?’

‘Will Wuzzle have some to drink, too?’

‘I’m sure he can. Would you like strawberry, blackcurrant or chocolate flavour?’

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