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Birth Defect and Pediatric Surgeon

As parents are becoming more concerned and aware they emphasize more on the scope and post surgical results when it comes to handling a surgical newborn. Though pediatric surgery offers a wide range with interdisciplinary sharing, the very crisp and dominant role comes when a newborn with Congenital anomaly( Birth defect) presents.

Birth Defect

It could be:

  • 1. Anorectal Malformation
  • 2. Intestinal Atresia
  • 3. Malrotation
  • 4. Tracheo-Esophageal Fistula
  • 5. Hirschprungs Disease
  • 6. Diaphragmatic Hernia
  • 7. Omphalocele
  • 8. Gastroschisis
  • 9. Spina Bifida
  • 10. Congenital Hydrocephalus
  • 11. Congenital cystic Adenomatoid Malformation( CCAM/ CPAM) in Lungs
  • 12. Neonatal Hernia
  • 13. Undescended Testis
  • 14. Hypospadias
  • 15. Antenatal Hydronephrosis

GASTROSCHISIS

It is an abdominal wall defect where the intestine lies hanging outside the abdominal cavity. Mostly it is detected antenatally and the mother is advised institutional delivery with availability of pediatric surgical team as after 20 min only the extruded intestine may get thickened with fibrinous exudate causing matting of intestine making surgery difficult and risking newborn to sepsis. So, ideally this is one surgery where the baby as soon as born, is taken immediately in the OT for covering the intestine to have the best result and culminate sepsis.

Perhaps in our country because of so many factors and lack of privileges, we are prepared to cater as per the situation and many a times they are not ideal.

INDEX CASE

Preterm 1.9 kg born in a village nearby Faridabad presented at 4 hours of life with hanging dusky bowel. After explaining and exploring all the possibilities and minimal chances of success as the colour of bowel wasn't good and added possibilities of atresia, midgut volvulus, short bowel etc...but parents took the decision to go forward with surgery. Sometimes Faith takes the steering and we do what best can be done. Of course surgery and post surgery had a stormy course but finally the zeal won. ( NATURE CHOSE THE CHILD)

Without going into surgical description will share the postoperative outcome , now at 3 years follow up. The picture says all. The child is happy and making most of childhood absolute normal for milestones.

What a blessing for a pediatric surgeon.

I'm sharing in the best interest of the group as many a times we are not aware of such challenges and possibilities. Congenital defect are treatable under optimal guidence. Thank you.