22 February 2012
A 15–day–old Nigerian baby, born with improperly developed food pipe, successfully underwent surgical correction of her digestive tract at a city hospital. The baby showed significant post–operative recovery and was discharged on Tuesday.
“It is a rare congenital defect, in which the food pipe connecting the mouth to the stomach is shortened and closed (dead–ended) at some point. The condition is called ‘esophageal atresia’. It affects approximately 1 in 4,000 live babies as in most cases babies get aborted because of the severe abnormality,” said paediatric surgeon Dasmit Singh, who operated upon the baby at Jehangir hospital on February 5.
“Normally, babies with such condition need to be operated within hours after birth. Otherwise the child dies. However, in this case, the child was operated after 15 days of birth. Even then, it has survived and done well,” Singh said.
The mother delivered twin babies in Nigeria on January 22, of which one died at birth. Two days later the parents were told that the surviving baby had potentially life threatening complications. Through an intermediary, the father contacted Singh, who assured him that the baby can be saved.
The parents reached Pune on February 2. “The child was rushed to the neonatal intensive care unit, where neonatologist Anshu Sethi and her team had to resuscitate the child as she was highly dehydrated and very sick. All the accumulated secretions were sucked out, the baby was started on oxygen and then investigated,” Sethi said.
“The baby was in no condition to be operated. She would not have survived the anaesthesia and surgery. So, in consultation with the parents, we postponed surgery till her condition stabilised and improved,” said Singh.
Anaesthetist Sudhir Phadke’s team handled the delicate task of anesthetising the 15–day–old baby weighing just 2.7 kg, while Singh, assisted by surgeon Kshama Kulkarni, carried out the surgical restructuring of her digestive tract.
During the surgery, the abnormal connection of the lower esophageal pouch was disconnected from the trachea. The trachea was repaired with stitches and then the upper esophageal pouch was sutured to the lower esophageal pouch, thus establishing continuity of the food pipe.
After eight days of surgery, a ‘dye study’ was done to test whether the food pipe had healed adequately. It showed that the healing was good, signaling that the child would be able to feed orally like a normal child, 22 days after being born.
“In such cases, good results are dependent on speed, teamwork, the facilities, the skill of the surgical and intensive care teams and, above all, efficient nursing care,” said George Eapen, CEO, Jehangir.
The baby has now gained almost 500 gram weight. She was discharged on Tuesday and was scheduled to fly to Nigeria.