Sidra Medicine on Sunday said it has succeeded in saving the life of a child with an paraduodenal hernia known as 'Omphalocele'. As a fetus in his mother's womb, the child was suffering from a major abdominal wall, which means that his bowels, liver and other organs were sticking outside the abdomen, in a sac.
During the consultations at Sidra Medicine, a multi-disciplinary team of physicians from maternal fetal medicine, neonatology and pediatric surgery met with the parents to discuss the options available regarding her baby's condition and the care that Sidra Medicine would be able to provide.
Prof. Karim Kalache
Division Chief of Maternal Fetal-Medicine at Sidra Medicine Prof. Karim Kalache, said: "Omphalocele is a rare condition that affects 1 in 5,000 births. Sidra Medicine has dealt with several cases in Qatar and we were well placed to guide the parents through the treatment and care process. It was critical to determine the size of the defect on the baby, which organs were affected, and to exclude associated anomalies. It was also important that the parents were aware of the risks and the opportunities of personalized care and treatment available. We discussed the wide spectrum of outcomes to ensure that Branca and her husband were able to make an informed decision regarding the birth and care program."
Following regular monitoring of both mother and baby, Branca gave birth to Mikhail via a planned caesarian section at Sidra Medicine. A team of specialists were on hand to ensure that Mikhail would receive immediate medical attention as soon as he was born.
Senior Attending Physician in General and Thoracic Surgery at Sidra Medicine Dr. Guy Brisseau, said: "Children born with Omphalocele can sometimes also have problems with their heart, spine, lungs as well as digestive organs. After Mikhail was born, he underwent a
Dr. Guy Brisseau
thorough check up and once it was determined that he wasn't at risk with other conditions, apart from the large Omphalocele, we elected to allow the skin on his abdomen to grow over. And that he would undergo the next procedure until he turned two or three years old. This method called the "Paint and Wait" technique that would assist in skin formation over the thin sac. It would allow his belly to grow and be stretched enough before surgery. The repair to his abdomen required that the process of care and treatment, be carried out in stages."
"Many different dressings are available to "paint" the thin sac to protect it from damage and bacteria. We also decided to use a new but ancient technique of honey dressings. Medicinal honey uses the natural ingredients of honey to physically protect the thin sac while we waited for the skin to grow over and protect the sac. Medicinal honey does not have the side effects of previous dressings," continued Dr. Brisseau.
Mikhail was admitted to Sidra Medicines Neonatal ICU as his condition required constant supervision, especially during feeding times as his intestines was partially outside his body.
Div. Chief of NICU at Sidra Medicine Dr. Charlotte Tscherning, said: "Mikhail stayed in our NICU for approximately two months. Feeding babies with Omphalocele is a challenge and
Dr. Charlotte Tscherning
requires specialist expertise. In order to support his growth, nutrition was given through a central venous line into the blood (parenteral nutrition). Mikhail was fully fed with milk at only one month of age. The milk was started slowly and was gradually increased."
Mikhail stayed in the neonatal ICU at Sidra Medicine for nearly two and a half months, after which he was discharged. Thanks to a regimen of medication, good skin care and nutrition, his health progressed. However, during the peak of Covid-19, Mikhail was rushed to the childrens emergency department at Sidra Medicine as he started to unexpectedly vomiting black- greenish fluids.
A gastrointestinal scan confirmed that Mikhail had developed an obstruction to his bowel, known as a paraduodenal hernia, a rare congenital anomaly where his small intestine became trapped. The potentially life-threatening condition needed to be treated immediately. Mikhail went into emergency surgery to fix the bowel obstruction. This surgery took three hours and involved a team of two surgeons, three anesthetists and three nurses. Given the need for emergency surgery, the surgeons decided they could also close his belly muscle and fix the omphalocele.
The surgery was a major success where the surgeons rectified the hernia as well as closed the abdominal defect without the use of any mesh. After spending eight days in the pediatric intensive care unit and floor, Mikhail was sent home, and recovered in two months. He still regularly comes to Sidra Medicine for check-ups.Last updated: June 13 2021 01:15 PM