Rare birth defect corrected in successful surgery in Dubai

In a case that occurs in one in 2,500 births, a man who had been enduring chest pain, fever and shortness of breath for the past three months was discovered having most of his organs lodged in the left chest.
Haq (name changed for confidentiality), a 33-year-old Pakistani, was diagnosed with left-sided diaphragmatic hernia, in which part of the organs from the belly move into the chest cavity near the lungs. The diaphragm is the muscle between the chest and abdomen that helps you breathe.
In this case, the left kidney, colon, spleen and the tail of pancreas were lodged in the hernial sac.
The patient was referred to the International Modern Hospital (IMH) for a laparoscopic surgery. "Since the condition is a birth defect, the treatment is always surgical, especially if the condition is severe," said Dr Sunil Channakeshava, specialist general surgeon at IMH.
Surgical options include the traditional open approach or a minimally invasive surgery such as laparoscopy. Dr Channakeshava and consultant gastrointestinal surgeon Dr Baiju Senadhipan performed a procedure called laparoscopic diaphragmatic hernioplasty with mesh and carefully worked through the challenges of the case.
"Most of the organs of the left side such as the spleen, tail of pancreas, splenic flexure of colon including the abdominal organs like left kidney were in the hernial sac. All these were safely dissected from the sac and brought back to the abdomen preserving their function and blood supply," said Dr Senadhipan.
It was possibly the first time that such a condition was treated via laparoscopy in the UAE, the doctors said. The patient recovered well and earlier than expected and was discharged in three days following the surgery.
Rarely seen in the country, particularly in adults, this condition usually manifests in newborns and can be diagnosed through an ultrasound prior to their birth. Albeit a rarity, 10 per cent of the cases presents in adults as well. It is more common in male infants compared to female infants. Patients with this rare birth defect suffer from gastrointestinal and/or respiratory symptoms, due to the irregular positions of the organs.
The gastrointestinal symptoms include either abdominal pain or vomiting. Among the respiratory symptoms are the acute onset of chest pain and shortness of breath that can even lead to fever, pleural effusion (a buildup of fluid in the pleural space, an area between the layers of tissue that line the lungs and the chest cavity), etc. The stated incidence of this condition generally applies to the global population; no separate studies have been conducted for the Gulf as of today.
asmaalizain@khaleejtimes.com

• Dubai