Breakthrough Surgery : 27-Day-Old Infant Cured of Rare Lung issue

Successful surgery of one in 10000 rare condition 

Bangalore. In a recent medical marvel, doctors at Aster RV Hospital, JP Nagar, Bengaluru successfully treated a 27-day-old male baby suffering from congenital lobar emphysema, an exceedingly rare condition causing abnormal lung lobe expansion, leading to critical complications in breathing and oxygenation.

27 day old male baby was brought to the hospital with complaints of breathing difficulty. Parents had noticed the child had discomfort in breathing since birth. The child was rushed to the hospital on observing continuous difficulty in breathing.  On examining, it was observed that the child had reduced air entry on the right side of the chest with nasal flaring and inter costal retractions. After stabilization, advanced diagnostic tests, including X-rays and CT scans, confirmed the diagnosis of congenital lobar emphysema affecting the right middle lobe. The baby was promptly admitted to intensive care for immediate oxygen therapy. Swift action was taken, transferring the baby to the operating room for life-saving surgery. Procedure was done with postero lateral thoracotomy.

Dr. Dhiraj Balaji, Senior Consultant, Paediatric Surgery, Aster RV Hospital, who operated on the baby explained, “We had to face Anaesthetic challenges while operating the 27 day old baby. The baby could collapse the moment relaxant was given. It was like an awake anaesthesia. After sedation, the chest of the child was opened, the Lung was delivered out and the baby improved instantly, anaesthetic relaxants were given later to bring baby to normalcy. The challenge with Neo Nat is, the lungs are very fragile. It was stuck with other parts of the body and major blood vessels, including the heart and other organs. This was inside the chest cavity, behind the ribcage. The lobe which was enlarged due to the defect was more than the size of both the lungs like a balloon. Surgery had to be done with utmost care and precaution. Post operation, the baby was shifted to NICU. It was on ventilator at the NICU on day 2, next day it was extubated, it was later shifted to the ward and was discharged on the 5th day.

This case was one in 10,000, a rare and intricate procedure. The defect Middle lobe of the right lung was rarest as the Commonest occurs on the left upper lobe. If the parents had delayed for another two to three days, it would not have survived. With the removal of one part of the lobe, the child can still perform normal activities and Vital capacity is not affected in the long run too”, the doctor concluded.

The baby’s father, who runs his own business at Ananthapur said, that it was a timely intervention. “When we took the baby to the hospital, it had a bloated stomach. Doctors said that the air was going inside but not coming out.  Air was getting trapped causing compression of the surrounding lung. The heart was pushed to one side and the opposite lung was also compromised. The baby’s oxygenation was completely deprived. Baby was in distress and hunger for oxygen. CT Scan and X-Ray helped diagnose the right side lung middle lobe expanding like a balloon making it difficult for the baby to breathe.”

The baby was immediately shifted to ICU and oxygenation was given. Once the oxygenation to the brain improved, baby was operated upon. The middle lobe of the right lung was defective. After taking oxygen inside, it was unable to throw the oxygen out causing it to bloat. A very carefully guided surgery gave instant relief to the baby. The middle lobe of the right lung was removed and the baby’s condition improved instantly.

The baby is now thriving well with good weight gain when examined on a follow-up routine check-up visit to the hospital. The successful intervention not only saved the baby's life but also ensured the possibility of a healthy and active life ahead. The baby's vital capacity and ability to perform regular activities remain unaffected, ensuring a promising future” the doctors informed.