John, 11, was enjoying the summer break with his family and twin brother, Raymond, when he started to feel his stomach hurting and it would not go away. What initially seemed to be something minor like constipation turned into an emergency when his mother noticed his eyes were bright yellow while swimming with him in the backyard pool. The pain was so severe that John, who typically does not like to go to the doctors, asked his mom to take him immediately.
Living in Palm Beach County, John's family rushed to the nearest ER where the medical team explained his liver was enlarged and would need further specialized care. At that point, John was rushed via LifeFlight ambulance to Nicklaus Children's Hospital Miami.
Once admitted, Dr. Maria Lopez Gonzalez, Nicklaus Children's pediatric gastroenterologist who specializes in advanced endoscopies, alongside the gastroenterology team, performed an Endoscopic Retrograde Cholangiopancreatography (ERCP). As the only pediatric children's hospital in South Florida offering this procedure, Dr. Lopez Gonzalez and team were able to detect John not only had an enlarged liver but also gallstones causing an enlarged gall bladder. The yellowing in John's eyes was caused by the gallstone traveling into the common bile duct, which blocked the normal flow of bile.
An ERCP diagnoses and treats issues in the bile ducts, gallbladder and pancreatic ducts. During the procedure, a doctor guides a thin and flexible endoscope through the mouth, down the esophagus, through the stomach and into the first part of the small intestine. The endoscope is then able to identify blockages, gallstones or narrowed ducts. In John's case, a gallstone the size of a small button was found, and the team was able to remove it during the ERCP using a small instrument passed through the endoscope.
After being closely monitored following the procedure, John's gallbladder remained enlarged. With a fear of compromising the liver if the inflammation persisted, the gastroenterology team along with John's family decided to remove his gallbladder. Pediatric Surgeon and Director of the Nicklaus Children's Colorectal Center, Dr. Juan L Calisto, surgically removed John's gallbladder using a minimally invasive technique in which a laparoscope, a tiny camera is inserted, allowing the surgeon to see inside the abdomen on a monitor. The gallbladder is then carefully separated from the liver and bile ducts. Compared to traditional surgical techniques, the laparoscopic removal offered John less post-operative pain, smaller incisions and a faster recovery.
“John's incident happened in what felt like an instant, one moment we were in an ER by our home and the next we were being rushed to Nicklaus Children's,” says Christina, John's mother. “While it was nerve-wracking to see the medical team act so urgently to find an answer to John's case, it was also so telling how much the doctors, nurses and experts at the hospital cared for my son and his health.”
While his gallbladder stole a couple of his days in the summer sun, John is back to playing in the backyard pool with Raymond and his family. He is excited to start 5th grade this fall!