A team of Dr. Bhavesh Doshi, Consultant Pediatric Surgeon and Dr. Neetu Mundra, Neonatologist successfully treated a one-year-old infant with a rare congenital malformation called Ano Rectal Malformation, which means the baby has no anal opening. After birth, the baby underwent five surgeries including colostomy, anal reconstruction and colostomy closure to address anorectal malformation (ARM) and other problems like hypospadias and tongue tie. Despite these challenges, the child is successfully reaching developmental milestones appropriate for his or her age.
Mr. and Mrs. Salian of Mira Road welcomed their first child into the world. However, their joy turned to shock when they were told that the newborn had a congenital disease called Anorectal Malformation (ARM), which resulted in the anus not opening. The child also had other problems like hypospadias, which means the penis was bent and the mouth of the urethra was not in place. The baby was immediately admitted to the Neonatal Intensive Care Unit (NICU) at Wockhardt Hospital, Mira Road and parenteral nutrition was started as breastfeeding was not possible.
Dr Neetu Mundra, consultant neonatologist and lactation expert, Wockhardt Hospital, Mira Road, said, “ARM (anorectal malformation) is rare, and often comes as a shock to parents as it is not diagnosed in the prenatal USG scan. May go. This is a rare disease and one child in millions is born with this defect. In the delivery room, all babies are examined from head to toe to detect any abnormalities, especially when they have any abnormalities.'' So, just as this baby had anal deformity in the delivery room, we immediately looked for other abnormalities. Searched for. He also had a bent penis, along with an abnormal position of the urinary meatus (hypospadia) and a tied tongue – a condition where the tongue is attached to the floor of the mouth, making it not possible to stick the tongue out which can lead to breastfeeding . Problems and difficulty speaking. After proper consultation of the parents, several surgeries were performed on the child.
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Dr Bhavesh Doshi, Pediatrician, Wockhardt Hospitals Mira Road, said, “The complete treatment of anorectal deformity was done in 3 surgical stages. At birth, a colostomy was performed. In this problem we have to create a temporary route (to create a bypass route for the stool, so that the baby can start feeding). At 2 months of age, a 4-hour long surgery called posterior sagittal anal rectoplasty (PSARP) was performed, where a new anus was created in a normal position. 2 months after the second surgery, the child underwent the final surgery for ARM, colostomy closure. During the surgery, the hole that was made in the abdominal wall has been closed and the baby is now moving through the normal hole.
Dr. Bhavesh further added, “Finally, at the age of one year, the child again had to undergo major surgery to correct the curvature of the penis and bring the urethra back to normal position. After a 3-hour long surgery, the child passed urine from a normal position at the tip of the penis.
Now the child is one year old and is capable of achieving all the achievements like his/her peers. The child underwent 5 surgeries till the age of 1 year. Explain the challenges facing the team. Dr. Neetu Mundra said, if treatment was not given at the right time, his development could have failed.
“We are grateful to the doctors for saving our child and giving us a new path to life. My child is now doing well and is at par with other children of the same age,” the Salian couple concluded.