Doctors operate on newborn’s, Doctors operate on newborn’s
The infant suffered from omphalocele which had caused liver and intestines to form outside the body in a thin sac
In September, 30-year-old Vidya Adgale from Keshav Nagar, gave birth to twins — a boy and a girl. While the boy turned out to be healthy, the girl was born with a rare congenital defect that affected the development of the muscles of the abdominal wall. Called as omphalocele, the baby’s intestines, liver and other organs were outside her abdomen in a sac. She underwent the surgery on the next day after her birth, which indeed saved her life.
Omphalocele occurs because of failure of normal return of intestines and other contents back to abdominal cavity during around ninth week of intrauterine development. This defect was corrected by doctors at Hadapsar’s Noble Hospital in a two-hour operation, where they immediately pushed some of her organs into her body. The urgency of the situation was highlighted by the statistics which say that mortality is as high as 80 per cent if a heart disease is involved and 30 per cent otherwise.
Dr Pranav Jadhav, paediatric and neonatal surgeon, and Dr Shriprasad Patankar, paediatric surgeon, immediately performed the exploratory laparotomy surgery. Also known as exlap, it is a surgical operation where the abdomen is opened and the organs examined for injury or disease.
Jadhav said, “The baby was born with abdominal wall defect and the liver, small intestine and other organs were outside the stomach of the baby wrapped in a thin cover. A space was created by stretching the narrow muscles of stomach. The liver, intestines and other organs were repositioned and then closed it. If the doctors fail to stretch the abdominal muscles properly, it can create pressure on the organs and major blood vessels, thus affecting the circulation. If the procedure fails, an artificial sac has to be created and the organs have to be placed back one by- one over a certain period.”
The baby was on ventilator support during and 72 hours after the operation to avoid respiration-related complications and others like infection and blood loss since the age and high mortality rate were already challenges. Regular dressing of the wound and total parenteral nutrition was provided till the baby reached full enteral feeds. She was discharged after three weeks after the surgery, on September 26.
The infant’s father, Vikas, said that he could breathe a sigh of relief after the operation as the family had been reeling from a lot of sorrow. “I was saddened to find out about my daughter’s condition. The high mortality rate and her age were a major cause of concern,” he said.
Dr Prashant Udavant, consultant paediatrician at the Ruby Hall Clinic also talked of the risks that result of the positioning of the organ. “Surgery is the treatment of choice although it is difficult due to the small size of the abdominal cavity and the large mass of intestines. In such cases, closure is sometimes not possible. The infant needs to be on antibiotic, other medicines and supportive care for long term,” Udavant said.
Surgery is the treatment of choice although it is difficult due to the small size of the abdominal cavity and the large mass of intestines. In such cases closure is sometimes not possible
— Dr Prashant Udavant paediatrician
Credit: Pune Mirror