With the death of 12-year-old boy Adebola Akin-Bright still fresh in mind, not a few Nigerians are yet to heal from the wounds inflicted by it.
While the late Adebola’s story evokes deep sympathy across the country until he died last Tuesday, a General Practitioner who had served with the Lagos State University Teaching Hospital (LASUTH), Ikeja in Lagos, said, “It’s really very sad and unfortunate that in this age and time, despite the much knowledge available via technology, such a simple surgery could be allowed to end an innocent child’s life. And, that’s the saddest part, I assure you.”
Shedding light on the human anatomy, the retired physician who preferred anonymity, said, “It’s important to understand that small bowel resection is the surgery often performed to remove a part of a person’s small bowel.
A specialized doctor knows that if the middle part of the small intestine is removed, the last part would adapt. But, should over three feet get removed, it is impossible for the remaining part to adapt
“It is usually required when part of the small bowel is either blocked or diseased. In fact, the small bowel is just about 12-21 feet, that is, about four meters in length.
“So, it requires specialized doctors called colorectal surgeons or proctologists who deeply understand conditions affecting the large intestine comprising the colon, rectum and anus.
“The specialist doctors are also familiar with the small intestine, which is the the longest segment of the gastrointestinal tract — the long, continuous pathway that food travels through the digestive system.
“In the small intestine, food is broken down into liquid and most of its nutrients are absorbed. The waste is passed on to the large intestine, which is where the problem occurred in the boy’s unfortunate case.
“A specialized doctor already knows that if the middle part of the small intestine, called jejunum, is removed, naturally, the last part, called ileum, would suddenly adapt and start absorbing more nutrients. But, should over three feet, that is, about one meter of ileum get removed, it is obviously impossible for the remaining small intestine to adapt.
Most people can live without a stomach or large intestine, but it is harder to live without a small intestine
“Ordinarily, removal of any of this part is an opportunity of giving the patient a new opportunity to live again. So, we see that where the problem began was the total removal of the small intestine by a person who did not know the techniques to be applied and who obviously didn’t realize that it cannot be completely removed.
“We have had cases, in my practising days, of some patients that underwent surgery to remove some of their small bowels for various reasons. For instance, I knew a case of a malabsorptive bariatric surgery, what is generally called gastric bypass to correct morbid obesity in order to limit the calories in the body to be absorbed by the small intestine.
“So, what may have likely happened in Adebola Akin-Bright’s case was that when the large or total part of his small intestine was removed or stopped working, he could be having problems with loose stools. For that, his body would be requiring enough, if not more, nutrients from the foods he was given to eat.
“Sadly, we don’t know the details. Another option was to be infusing nutrients directly into his blood stream via intravenous (IV) in liquid form.
where the problem began was the total removal of the small intestine by a person who obviously didn’t realize that it cannot be completely removed
“Most people can live without a stomach or large intestine, but it is harder to live without a small intestine.”
Asked where Dr. Abayomi Baiyewu, who performed two controversial surgeries on Adebola, erred, the retied doctor said: “This issue is really dicey because there are still some grey areas that need to be clearly examined.
“Yes, our colleague erred because he could have invited an expert in that area, but more technical information is still being required as we await further information as the investigation progresses.”