Published on March 15, 2020
AHMEDABAD: When Usman, a nine-month-old boy from Rakhial, was brought to the paediatric ward of Civil Hospital a fortnight ago with high fever, cough and breathlessness, doctors advised an X-ray and a CT scan. Their results surprised the medical team.
The infant had a rare condition, ‘situs inversus totalis’ which involves complete transposition (right to left reversal) of thoracic and abdominal organs. Usman’s heart is thus not in the usual position in the left of the chest, but on the right this is the case with his other organs too. This was not it. He had a second condition, diaphragmatic hernia, which resulted in the development of intestines on right side of his lung.
Dr Rakesh Joshi, professor and head of paediatric surgery at Civil Hospital, said this was the first surgical procedure at the hospital during his tenure where an infant was found to have these conditions together. While diaphragmatic hernia is very unusual but not rare in newborns, mirrored organs are found in just 0.01% of the population, Joshi said.
A team consisting of Dr Joshi, Dr Jaishri Ramji and other experts performed corrective surgery on February 28, to correct the hernia and restore the intestines to the lower abdomen. Usman was kept under observation for a fortnight and was discharged on Friday. The team said that he will come for a few follow-ups, but his his health is improving.
“The first child of a cab driver, Usman was developing pneumonia. The development of his small and large intestines along with splenic tissue in his chest cavity was constricting his other organs such as lungs, heart and liver, causing health complications,” said Dr Joshi.
Dr Gunvant Rathod, medical superintendent of Civil Hospital, said only a few such cases have been reported worldwide where both these conditions are found together. “It’s a feat for the surgeons and I am sure it will set an example for the state’s paediatric surgeons,” he said.
What if the surgery was not done in time? Dr Joshi said the mortality rate in diaphragmatic hernia is 50%-60% when combined with other complications.