Risky surgery saves newborn who couldn’t breathe

By Divi S.

Dr. Elghote Dr. Sridhar and baby Nirbhal with his family

DUBAI 16 January 2019: The neonatal unit team at Zulekha Hospital Dubai saved the life of a new born baby, born with breathing difficulties.

The infant’s diaphragm (which is a muscle that separates the chest and abdominal cavity) had a defect and the baby’s abdominal contents which include the intestine and liver had climbed into the chest cavity through a hole (condition called congenital diaphragmatic hernia).

This happens early during the mother’s pregnancy and interferes with the normal growth of the baby’s lungs – leading to poor development of the lung known as lung hypoplasia.

Once the diagnosis was made due to difficulty in breathing and maintaining oxygenation, the baby was transferred from another private hospital for expert management and was admitted to Zulekha Hospital’s neonatal intensive care unit (NICU). The case was managed by the Neonatal team led by Consultant Neonatologist Dr Sridhar Kalyanasundaram, and the Paediatric Surgeon, Dr Salah Elghote.

Rare Ailment

Congenital diaphragmatic hernia is a rare life threatening congenital anomaly-the high mortality arises from the lung hypoplasia which makes it difficult to save these babies even in expert hands. In many cases this deficiency is picked up and diagnosed during pregnancy from the 20 week scan where a stomach bubble is seen in the chest, which alerts the radiologist to this problem. However, in some cases and in this case, the diagnosis was made due to a breathing difficulty after birth.

High Risk Surgery

Surgery was essential to repair the hole as the child was very sick and would deteriorate rapidly if not stabilised and treated. There are very few hospitals who offer this kind of surgery due to the high risk of mortality and the high level of intensive care support needed in the pre and post-operative period to support oxygenation in the setting of poorly developed lungs.

The team at Zulekha Hospital Dubai, keen to save the baby’s life proceeded with the surgery performed by the expert peadiatric surgeon Dr. Salah Elghote (Specialist Paediatric Surgeon & Paediatric Orthopaedic Surgeon) along with the anesthetist team with peadiatric expertise. The neonatologists led by Dr. Sridhar Kalyanasundaram, Consultant Neonatologist were also fully involved during the surgery to support the procedure.

Dr. Salah Elghote identified the defect in the left diaphragm. After placing the intestinal contents back into the abdomen from the chest cavity, the doctor then repaired and closed this defect. Following the successful surgery and a critical postoperative period the baby survived and was discharged in 18 days following the operation.

Chance Defect

“Congenital diaphragmatic hernia is the malformation that the baby was born with. It is not usually genetic or inherited but the congenital malformations happen by chance due to defective tissue development.” said Dr. Elghote.

Thanking the team at Zulekha Hospital Dubai, the parents expressed their thankfulness stating, “We appreciate the team’s efforts in helping our baby survive and lead a normal life. It has been a difficult situation and the assurance from the doctors helped us regain strength in believing that things should be fine for our child”, said the proud parents.

“It is a pleasure for us to see the family happy after such a stressful period, knowing the baby has a serious condition needing treatment. The Neonatal intensive care unit is fully equipped to deal with such complex surgical and nonsurgical cases, and we have many such success stories.” added Dr Sridhar.

Dubai Gazette