West Bloomfield 20-Year-Old Gets a Second Chance After Treatment for Rare Digestive Disorder

Like many active teenagers, Isabella Crank enjoyed a busy and fulfilling life.

The West Bloomfield resident spent her time playing basketball, boxing and gymnastics, attending concerts, shopping and spending time with friends. But during her junior year of high school, subtle symptoms began to emerge that would eventually reveal a rare digestive disorder and dramatically alter her life.

“In 2023, during my orientation for a waitress job, I vomited multiple times,” Isabella recalls. “I was told I could go home, but I wanted to finish my shift, so I stayed even though I was intensely vomiting.”

At first, she assumed she had eaten something that didn't agree with her. But over time, the symptoms worsened. Severe abdominal pain accompanied the vomiting, her appetite disappeared and she began losing significant weight.

An ER visit provides a critical clue

As Isabella's condition deteriorated, her family searched for answers.

Her mother, Traci Watkins, a nurse at a local hospital, says they consulted multiple specialists and underwent numerous tests.

“After suffering from repeat vomiting and excruciating pain to the point that she thought she was going to pass out, we ended up in the emergency room at Henry Ford West Bloomfield Hospital where she received IV fluids,” says Traci.

When Isabella returned to the emergency department just 10 days later with similar symptoms, a CT scan revealed a possible diagnosis: Superior Mesenteric Artery (SMA) Syndrome. SMA syndrome is a rare condition that causes compression of part of the small intestine, making it difficult to eat, digest food and absorb nutrients.

Doctors referred Isabella to Henry Ford Health Henry Ford Health General and Bariatric Surgeon Dr. Puraj Patel.

“At the time, we had never heard of SMA syndrome,” Traci says. “When we heard a referral to a general surgeon was recommended we weren’t ready to jump into surgery, so we decided to go where we normally get our care from to see if there were additional tests to rule out other causes.”

Life becomes defined by hospital visits and feeding tubes

The search for answers continued.

Over the following months, Isabella’s weight plummeted to 89 pounds. She endured countless medical appointments, multiple hospital admissions and feeding tube treatments that consumed much of her day.

“She had to quit Schoolcraft College and leave her job as a waitress,” Traci says. “At one point, it felt like we were spending more time in the hospital than we were at home.”

Eventually Isabella was referred to a general surgeon at her local hospital, but the surgeon did not feel that she had SMA and would not benefit from surgery. “They just recommended that she receive a J-tube for feeding but we were not convinced about the treatment, so we decided to seek other opinions and go back to Henry Ford West Bloomfield to see Dr. Patel as well as seek input from a surgeon in Virginia.”

Finding confidence in a treatment plan

After meeting with Dr. Patel, both Isabella and her mother felt they had finally found the right path forward.

“It was like a breath of fresh air,” Traci says. “We finally felt heard and understood. Dr. Patel answered the questions we had before we could even ask them. He was very knowledgeable and down-to-earth.”

The family had planned to compare recommendations from both specialists before making a decision. Instead, the choice became clear during their first visit.

“At that moment, Isabella had no doubt in her head that she wanted surgery with Dr. Patel and trusted him,” Traci says. “We scheduled surgery before we left the office and canceled the appointment in Virginia.”

A gold-standard surgical solution

Dr. Patel recommended a minimally invasive procedure called a duodenojejunostomy (DDJ), considered the gold-standard surgical treatment for SMA syndrome.

The procedure is performed robotically and bypasses the compressed portion of the small intestine by connecting the duodenum directly to the jejunum, allowing food to pass normally and relieving the obstruction responsible for symptoms such as pain, nausea and vomiting.

"Most patients are so aware of their body, because of all they've been through -- going through so many procedures, tests, and studies -- that they immediately know the difference after taking just a sip of water in the recovery room," explains Dr. Patel.

The robotically performed DDJ typically requires an overnight stay in observation to monitor vital signs and to restart a diet.

Dr. Patel adds that the ultimate goal of these procedures is to get patients back to their normal lifestyle. “For Isabella, that meant going to school, having a social life, being a typical 20-year-old, and eating pizza."

Immediate relief and a return to normal life

The results of the successful surgery were almost immediate.

“Even in the recovery room, Isabella was already feeling better than she had in the entire past year,” Traci says. “The constant nagging pain that we were previously told was likely nerve pain was gone, and she rarely needs the anti-nausea medication she had been taking multiple times a day.”

Traci says Isabella was eager to get moving after surgery. “Once she got up in recovery, she was constantly walking, ready to eat and was discharged the next day.”

As Isabella regained her ability to eat normally, she no longer depended on tube feedings. One month later, the feeding tube was removed.

“I cried tears of joy when it was removed because there was a time when I thought I would need it for the rest of my life,” Isabella says.

Looking ahead

Today, Isabella is enjoying the things she once feared she might never do again.

“I can enjoy food again, started hanging out with my friends and doing things that 20-year-olds should be doing,” she says. Her future plans include returning to work and continuing her education.

“I plan to pursue a radiology degree so I can help people who are in a position that I was once in.” For Traci, the impact of the care Isabella received extends far beyond the successful surgery itself.

“I don't think Dr. Patel understands how much he has changed our life,” she says. “We are forever grateful for him. Not just because he performed the surgery, but because he was so kind and listened to us. He kept in touch after surgery to see how she was doing, whether she was tolerating foods and checked in again after the J-tube was removed. He's one of a kind.”