Considered one of the rare case
5-hour surgery to reinsert the newborn’s organs into their internal cavity successfully
Abu Dhabi – 20 May 2017: Surgeons in Abu Dhabi saved a newborn with a deformity consisting of small intestine, and the whole liver to extrude outside his trunk, hanging in a huge spherical shape sealed by thin membranous lining at the level of umbilicus. The newborn underwent a major surgery 2 weeks after birth which lasted for five hours and was completed successfully.
Dr. Raja Cingapagu, Pediatric Surgeon, at Danat Al Emarat Hospital for Women & Children in Abu Dhabi who performed the surgery, stated that “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 that “Tests performed on the fetus during pregnancy and the newborn after birth showed absent muscles in the central abdomen around the navel, which led to parts of the stomach, small intestine, and liver extruding outside the abdomen in a spherical sac measuring around 7 centimeters in diameter. The sac was sealed by the umbilical cord lining, which allowed the organs to remain well preserved while outside of the body.”
“It was decided to perform the surgery to return the organs 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, “After two weeks of the birth, the newborn underwent a major 5-hour surgery, during which 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 that were being returned. 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.” Dr. Raja confirmed that the operation was successful, and that 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 categorized as a congenital disease. He confirmed that these cases require a highly qualified medical team of varied specialties.
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. This allows for an appropriate treatment plan to be put in place to continue treating the child after birth. She indicated that Danat Al Emarat Hospital had an advanced fetal medicine unit encompassing the latest medical diagnostic tools.
The father of the child Ashraf Abunar expressed his happiness with the success of the operation conducted for his son, and the attention received by the medical team in the hospital since the discovery of the situation before birth in weeks and during delivery and beyond.
He said, “We felt somewhat worried as we saw our son after birth and how his internal organs were outside the abdominal wall. However, the attention and care my son received from the very first moment and the provision of the best healthcare services in the hospital contributed to alleviate us. Throughout our journey, the medical staff provided a detailed explanation to me and my wife about our son’s condition and the treatment plan.”
“Danat Al Emarat Hospital for Women & Children has been keen from the beginning to provide comprehensive healthcare services by a highly qualified medical team caring for my wife and child, which contributed to the success of the treatment plan and my son to be treated without any complications”, the father of the newborn concluded.