I need all the fresh eyes and opinions possible on this one for Lizzie. To recap, she has had seven major abdominal surgeries; primary diagnosis was colonic inertia, then rectal inertia. She had a total colectomy, emergency ileostomy, reversal, K-pouch (which failed), K-pouch revision (also failed), end ileostomy, then they had to move her stoma to the left side of her abdomen. Her last surgery was at the end of November 2010. For awhile, she was having surgery every three months. After her last surgery, she was able to eat better, but soon every bite caused severe nausea, distention, and all the symptoms of an obstruction. The ER would X-ray or CT and not find one. They did a feeding tube (PGJ) for about two months, and she was able to start eating by mouth again with minimal symptoms. The tube was removed, she did ok for another month, and now things are horrible. Two bites of anything will cause distention, nausea, and vomiting. She eats extremely bland and still can only keep a couple hundred calories down every day.
On Wednesday they did an MR enterography (basically a gut MRI after drinking contrast), and it was negative for kinks, twists, strictures, or narrowings. Insert complete and total confusion here!!! She is miserable and just wants to be able to live and keep food down. A new internist ran a ton of labs last Friday...we don't know those results yet, but he checked CBC, CMP, albumin, all B vitamins, vitamin D, thyroid, and several other things. He felt that she would probably need TPN; she hasn't had her follow-up with him yet, though.
So, my question is: does anyone have ANY ideas?! Has anyone experienced this or anything like it?? Any ideas are GREATLY appreciated!
Thank you so much!
Constant vomiting...please read and brainstorm!