October 4, 2013

Dr. Damian Maxwell examines baby Benjamin 2 weeks after surgery.First-time mom Melissa Campos knew something was wrong with her newborn baby.

In late July at just 3 weeks old, Campos' son, Benjamin, started severely projectile vomiting every time he tried to nurse or take a bottle. Until then, he had eaten normally and had been a perfectly healthy baby.

"It was the scariest thing I had ever seen," Campos said. "Every baby spits up, but I was thinking that my child shouldn't be vomiting like this."

Doctors suspected different allergies and made numerous changes to Benjamin's diet. But the vomiting continued.

After multiple visits to the ER and pediatricians with no improvement, an Internet search ultimately pointed Campos in the right direction as to what could be wrong with her baby.

"I found something called pyloric stenosis, and I told my husband, 'this is it, this is what he has!' He had every symptom – it just had to be it," Campos said.

The pylorus is a muscular valve that holds food in the stomach until it is ready to pass to the intestine. Pyloric stenosis is a blockage of the pylorus, which prevents food from passing from the stomach to the intestine. This causes a baby to vomit.

A physician's assistant listened to Campos' suspicions and tested Benjamin for the condition, which came back positive. Benjamin was immediately transported by neonatal ambulance from Camden Clark Hospital in Parkersburg to CAMC Women and Children's Hospital where pediatric surgeon, Dr. Damian Maxwell, took over his care.

"An ultrasound confirmed that his pyloric muscle was too thick and a little too long, which caused a gastric outlet obstruction," Maxwell said. "So all the milk and formula he was eating didn't get past the stomach and caused him to vomit."

On Aug. 6, Maxwell performed a laparoscopic pyloromyotomy on 25-day-old Benjamin, which is a procedure using three tiny incisions, a camera and surgical instruments to open the muscles around the pylorus and allow food to pass from the stomach to the small intestine normally.

With his advanced fellowship training in pediatric surgery, Maxwell performs procedures like the pyloromyotomy using minimally-invasive techniques, whereas some pediatric surgeons perform the same procedure using open surgery.

Campos and her husband were relieved to learn that Maxwell specializes in laparoscopic surgery, which involves smaller incisions, a shorter recovery and fewer complications.

Maxwell completed his general surgery training at CAMC in 2006 and practiced with the West Virginia University staff for five years before completing a fellowship in general pediatric surgery at Montreal Children's Hospital. Maxwell's return to CAMC as a pediatric surgeon means more West Virginia children have access to the widest range of treatment options and the most advanced procedures at Women and Children's Hospital.

"We only have a couple pediatric surgeons in the state, which was part of my motivation to get this training and return to the community to provide this service," Maxwell said. "I've always had a love for pediatric surgery. Maybe I've just remained a kid at heart all these years!"

Maxwell understands the unique medical needs of infants and small children, which is critical to diagnosing conditions like pyloric stenosis and treating them effectively.

"Children are not 'little adults,'" Maxwell said. "Their physiology is different, how they react to dehydration is different, and when they have problems often their heart rate will fall and they can have respiratory difficulty, which is also slightly different from an adult. They also have a limited amount of reserves, so once they get into trouble you have to act quickly."

Maxwell immediately recognized the cause of Benjamin's distress because of his advanced training.

"A lot of babies spit up, so it can be seen as just reflux, gastroenteritis or another type of infection," Maxwell said. "But constant, real projectile vomiting, which is more forceful than usual spit-up, can be very dangerous."

Thanks to a little research and a new mom's instinct, Benjamin got the care he needed and went home the day after his surgery. Today he is a healthy, happy baby who is eating well and has fully recovered.

"He's doing great," Campos said. "His scars are smaller than one of his fingernails, and he's back to being an absolutely perfect baby."

Campos' advice to any parent who thinks something might be wrong with their child: trust your instincts.

"If you feel it in your gut, keep going back," Campos said. "Stomp your feet if you have to. If you get turned away, keep going back."

For more information about pediatric surgery at CAMC, visit camc.org/pediatricsurgery.

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