UAE doctors save baby's life in 5-hour-long rare surgery

Surgeons in Abu Dhabi saved a newborn with a deformity consisting of small intestine and the whole liver that was extruding from his trunk and hanging in a huge spherical shape sealed by thin membranous lining at the level of umbilicus.

The newborn underwent a major surgery two weeks after birth which lasted for five hours and was completed successfully.

Dr Raja Cingapagu, Pediatric Surgeon, at Danat Al Emarat Hospital for Women and Children in Abu Dhabi who performed the surgery said, "The newborn was diagnosed at 12 weeks of pregnancy at the hospital's Fetal Medicine Unit, which was essential to prepare a treatment plan by different specialties at the hospital including the obstetricians, the fetal medicine specialists, the pediatric surgeons and the neonatologists. The mother was placed under observation until delivery which was scheduled at the 37th week of pregnancy."

Dr Raja added tests performed on the fetus during pregnancy and the newborn after birth showed muscles were absent in the central abdomen around the navel, which leads to parts of the stomach.

"The small intestine and liver were outside of the abdomen in a spherical sac measuring around seven centimetres in diameter. The sac was sealed by the umbilical cord lining, which allowed the organs to remain well preserved while outside of the body," he said.

"It was decided to perform the surgery to place the organs back inside the abdominal cavity and to treat the hernia closing the abdominal wall muscles. However, this required preparing the newborn using a pressure belt around the sac of organs to reduce its size and increase the capacity of abdomen to accommodate the organs in preparation to return the organs to the abdominal cavity, a process which continued for two weeks at the Neonatal Intensive Care Unit (NICU)," Dr Raja added.

He added, "During the surgery the umbilical lining was removed, abdominal muscles were restructured and the various organs were returned to the abdominal cavity."

"Simultaneously, an advanced device was used throughout the surgery to ensure that the child maintained regular arterial pressure in the abdominal compartment thereby ensuring the safety of the organs. At the end of the surgery, the opening in the abdominal wall muscles was closed while ensuring this caused no undue pressure on the vital organs in the abdominal cavity."

The child was discharged from the NICU a week after the surgery. He indicated that these cases are considered very rare, only happening once in around 20,000 births, and with different rates and sizes of organs extending outside the abdomen.

He clarified that there was no known reason for this occurrence, and that these incidences are categorised as a congenital disease.

Dr Fareeda Banu Jahangir, Fetal Medicine Specialist at Danat Al Emarat Hospital had diagnosed the child's condition early on in week 12 of pregnancy, which helped begin the process of running further investigations, keeping the mother under observation, as well as informing the parents of the condition and the required treatment to be performed after birth.

Dr Fareeda emphasized the importance of fetal medicine in diagnosing various diseases and conditions that the fetus may have starting from the early stages of pregnancy.

The father of the child Ashraf Abunar expressed his happiness with the success of the operation conducted for his son.

"We felt worried when we saw our son after birth and how his internal organs were outside the abdominal wall. Throughout our journey, the medical staff provided a detailed explanation to me and my wife about our son's condition and the treatment plan."

Source: Khaleej Times