Two months ago, Yuki had a severe bout of gastroenteritis, needing to be put on a drip and hospitalised overnight, but she recovered well. It was just a week after this that a new problem started: she developed a large, firm swelling on her left side, just behind her rib cage. The swelling started off like a golf ball, but over two days it swelled up to the size of a melon. Yuki flinched when the swelling was touched: it was painful.
When Ansa brought her to see me, I had to try to find the cause of the swelling, so that I could give her the right treatment to cure it. There was a long list of possible causes, ranging from infections to cancer. I took x-rays, which showed me the detailed structure of the swelling and its position in her body. It was on the outside of her chest and abdomen, just under the skin, and it was made of “soft tissue”, with no involvement of bones or other structures. I also took a biopsy sample, and this ruled out cancer: I knew then that this was some sort of inflammatory reaction, probably due to infection or perhaps a “foreign body”. This is the term that’s used to describe something alien to the body, like a splinter or a grass seed. Even though I knew that this was the likely diagnosis, I also knew that it would be difficult to locate and remove it. The procedure would be just like looking for a needle in a haystack, and while cutting through the swelling looking for the foreign body, there would be a risk of damaging Yuki’s vital structures.
I put Yuki onto a course of antibiotics, which would cure an infection. Over ten days, the lump shrank down until it had nearly vanished. A small, golf-ball sized lump was all that remained. At this stage, we stopped the antibiotics, hoping that the problem was solved. Almost at once, the lump started to get bigger again, soon returning to the size of a melon.
Next, I booked her in for an MRI scan. This would identify the detailed location of the foreign body that I suspected, and this would guide me to carry out precise surgery to remove it.
While waiting for the MRI appointment, I received a WhatsApp message and photo from Ansa: the swelling had suddenly burst, and a small piece of wood had popped out. The cause of her problem had now been revealed and solved. We now know that Yuki had chewed a wicker basket, which had upset her stomach, and a piece of wicker had first, pierced her stomach wall, travelling up through her abdomen and out through the skin. Yuki’s body had ejected the wood causing the problem.