Baby with Rare Condition Undergoes Expert, Life-Saving Surgery at CHOC

Lizette Lough, experiencing a seemingly normal pregnancy, was making final preparations to welcome her first baby, when her water unexpectedly broke at 33 weeks. She was rushed to San Antonio Regional Hospital in Upland, close to home, where her son Landon was born early on May 3, 2016.

After a few days in the hospital, Lizette and her husband Sean noticed the baby had not made a bowel movement. Tests revealed that Landon had an obstruction in his intestine. His physician recommended Landon be transferred immediately to CHOC for an emergency surgery with Dr. Peter Yu, a pediatric general and thoracic surgeon.

“My husband and I lost it,” Lizette says. “Our baby was only three days old and weighed about 4 pounds. The thought of surgery was beyond frightening.”

Upon arrival at CHOC, the Loughs were immediately made to feel at home by the staff, who helped them find a nearby hotel. Dr. Yu explained every scenario of the complex surgery in a compassionate and confident manner, the Loughs recall.

Dr. Peter Yu, pediatric general and thoracic surgeon at CHOC.

“Landon was in stable condition when he arrived at CHOC, and I’m very pleased that our expert transport team was able to get him here quickly and safely. If there had been a delay in transfer, Landon could have become very sick and it’s very possible that more of his intestine could have died.  If that would’ve happened, he may not have had enough bowel to adequately digest food, which can be incompatible with life,” Dr. Yu says.

Landon was diagnosed with jejunal atresia, a rare condition – approximately 1 in 5,000 births – in which the small intestine is incompletely developed, leading to one or more gaps, or blockages, in the intestinal tract.

Lizette had gone through the required genetic tests prior to Landon’s birth, and jejunal atresia – often diagnosed prenatally – was not detected.

Additionally, Landon had malrotation of his intestines, which failed to coil in the proper position in the abdomen. This led to twisting of his bowel. If surgery had been delayed for longer, Landon could have died.

Landon’s surgery involved making an incision on his abdomen, examining the entire length of his intestine and untwisting it, removing the dead bowel, stitching together his small intestine, and performing a Ladd’s procedure. A Ladd’s procedure places the intestines back into the abdomen in a safe configuration to prevent future twisting of the bowel.

Landon, recovering in CHOC’s surgical NICU.

Sean, who works as a law enforcement officer, recalls how traumatic this was for his family. “I’m used to working in stressful situations, but this was a different kind of stress,” he says. “We were so happy that our baby had a successful surgery and that he was better. However, we were still waiting for him to have his first bowel movement. We were trying to stay positive.”

After his first bowel movement indicated that his intestines were recovering well, and spending about a month in CHOC’s surgical NICU, Landon was finally able to go home with his family.

“It takes a team to successfully care for sick babies and complex patients,” Dr. Yu explains. “Landon would not have had the excellent outcome that he had without our wonderful neonatologists, experienced and skilled pediatric anesthesiologists, Melissa Powell, our dedicated surgical neonatal nurse practitioner, and the outstanding NICU nurses who have dedicated their lives to taking care of newborn babies such as Landon and countless others.  Together, we have the only dedicated surgical NICU in the area, with a special focus on taking care of newborns with surgical problems.”

Landon today at 11 months.

Thanks to the expert multidisciplinary care provided at CHOC, today Landon is a happy baby, meeting all his milestones. The Loughs are enjoying their brave little boy, and look forward to his first birthday next month.

“Dr. Yu, as well as the nurses in the NICU, were so empathetic and amazing. They saw us through so much throughout our stay and we will forever be thankful,” Lizette says.

Learn more about surgical services at CHOC.

In the Spotlight: Peter Yu, M.D.

Peter Yu, M.D. A new pediatric surgeon with unique expertise in fetal surgery has joined CHOC Children’s Specialists Pediatric Surgery. Dr. Peter Yu specializes in the full spectrum of pediatric surgery, including neonatal, thoracic, and hernia surgery, and has quickly become an integral part of the surgery team.

“I’m extremely happy to be at CHOC,” Dr. Yu says. “There is so much talent and potential here, as well as a pioneering spirit and willingness to undertake big things.”

He is working closely with Dr. David Gibbs, division chief, pediatric surgery, CHOC Children’s Specialists, and Dr. Mustafa Kabeer, pediatric surgeon, CHOC Children’s Specialists, to launch a multi-disciplinary fetal surgery program at CHOC in the near future.

This highly complex surgery was uncharted territory about 30 years ago, Dr. Yu says. Many advances have been made in the field since, including new techniques that have allowed for the in utero surgical intervention of previously unsurvivable conditions. With special training from The Children’s Hospital of Philadelphia, one of the pioneering institutions in fetal surgery, Dr. Yu is determined to bring that level of expert care to CHOC and add to his team’s scope of services.

Among his goals, he hopes to help his team enhance the trauma program, advance CHOC’s minimally invasive surgery program, and increase CHOC’s national reputation through quality patient care and innovative research.

A passion for pediatric surgery

Dr. Yu followed in his older brother’s footsteps to become a doctor and attended Stanford University for his undergraduate studies. He graduated from the medical school at University of Missouri School of Medicine, where he fell in love with the culture and technical aspects of surgery, as well as the potential to make sick patients better quickly.

“I realized that the best surgeons were kind, dedicated, hard-working and team players – traits that I really value. When I discovered pediatric surgery, I felt it was a perfect fit for me, as it allows me to take care of children with an incredibly broad spectrum of pathology through surgical excellence,” he says.

Dr. Yu completed his general surgery residency at University of California, San Diego, followed by a surgical critical care fellowship at Boston Children’s Hospital and a pediatric surgery fellowship at The Children’s Hospital of Philadelphia. Additionally, he is board certified in general surgery, pediatric surgery and surgical critical care, and is currently working on a master of public health degree from Johns Hopkins Bloomberg School of Public Health.

This dedicated physician is interested in outcomes research to better understand the end results of specific health care practices and interventions.

“We presently live in an era where massive amounts of data are available at the click of a few buttons. The roadblock for many physicians is that we often don’t know how to access this data or organize it,” Dr. Yu explains. “My goal, along with my partner, Dr. Yigit Guner, as well as the division of pediatric general and thoracic surgery at CHOC, is to build an outcomes research center. This center will help all CHOC physicians access healthcare data and turn it into something meaningful so that we can provide the highest quality of clinical care to our patients, and do so in a financially sustainable manner.”

Dr. Yu has given numerous national presentations at meetings such as the American College of Surgeons Clinical Congress and the Association for Academic Surgery and Society of University Surgeons Academic Surgical Congress. He is a member of several organizations, including the American Pediatric Surgical Association and Society of Critical Care Medicine.

In his spare time, he enjoys spending time with his wife and three children. He also enjoys surfing, basketball and competitive swimming on a local U.S. Masters swim team.

To get in contact with Dr. Yu or to refer a patient, please call 714-364-4050.