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Case study: Ischaemia of the bowel.

MagazineNovember 1992 (Vol. 3 Issue 8)Case study: Ischaemia of the bowel.

My mother had been very ill for two years wit stomach pain, diarrhoea and loss of appetite

My mother had been very ill for two years wit stomach pain, diarrhoea and loss of appetite. She had numerous Barium meals and other unpleasant tests. During this time she was in and out of hospital and they couldn't find a true diagnosis. We were told it could be irritable bowel syndrome, a growth, Crohn's Disease, colitis or adhesions following a previous stomach operation. Repeat tests were done which proved all clear again. In May it was discovered that she had a blocked artery leading to her intestines. This obviously caused a restricted blood supply and so it was decided that an operation was needed. By this time my mother weighed only 5 stone 7 pounds and was very frail. She had only been allowed clear soup and a powdered food supplement for nearly two months because whenever she ate she suffered agony.

Eventually she was diagnosed as having ischaemia of the bowel. We were told her condition was very rare and that is why it took so long to diagnose; by the time they performed the bypass operation she was very weak and she died soon after. I would like to know whether her condition was that rare and therefore whether it should have been investigated earlier when she would have been spared so much suffering and had a much better chance of survival.Your terrible story is an object lesson in bad hospital management and diagnosis. Undoubtedly your mother would have had a better chance at surviving a risky operation had her condition been diagnosed before she had become so weak and frail. As you can see in the material you sent us, ischaemia of the bowel, or narrowing of the mesenteric artery, can prevent the blood supply necessary for the digestion of food from reaching the gut. If caught early , so long as the mesenteric artery is not entirely blocked, bypass surgery can save a victim's life, although one study in 1977 (Braunwals, E. New England Journal of Medicine 297: 663)showed that if the blockage is severe, patients do not live any longer after surgery than they would if left untreated. Furthermore, as in other cases of hardening of the arteries, many patients who undergo angioplasty or bypass surgery go on to have a recurrence.

As you have offered her story in the hope that others don't suffer as your mother did, we would widen its implications. Anyone with any problem that is not improving under the care of one practitioner or consultant should have no compunction about seeking a second opinion. If one doctor says he cannot find a true diagnosis, get your records and the results of your test and march as quickly as you can into the office of another, unrelated consultant. Being assertive, complaining and insistent about your medical care is the attitude most likely to keep you alive.

Although nothing we can suggest will bring your mother back, you may consider contacting Action for Victims of Medical Accidents to see if the hospital was guilty of negligence. (Bank Chambers, 1 London Rd, Forest Hill SE23 3TP).

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