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The Times of India, By Our Health Reporter
AHMEDABAD: A month-old infant Kamlesh Virwal was saved from succumbing to a rare disease called bilateral Congenital Diaphragmatic Hernia (CDH) - an absence or defect in both right and left parts of diaphragm - following a complicated surgery recently performed at VS hospital in the city.
Kamlesh was admitted to the hospital on March 24 with a server respiratory distress and an abdominal bulge in the epigastrium. recalling the condition of the patient, Dr N Bhattacharjee, eminent paediatric surgeon at the hospital, said the child was on the verge of dying as he was redered breathless by the compressed lungs.
On investigation, it was found that he suffered from bilateral CDH, one of the rarest defects found in children.
In this, lack of diaphragm results in all abdominal contents, including intestine, being displaced into the chest cavity, there by causing acute compression of the lungs.
Since the respiration is severely distressed, it can result in the immediate death of patient.
Dr Bhattacharjee said that CDH occurs once in 2000-5000 births - of which one-thirds are still-born.
Despite treatment, the mortality rate for the two-thirds is as high as 50 per cent. More over, the "bilateral" involvement of the diaphragm is an extremely rare condition. Out of the 1,359 admissions annually at the paediatric surgery department of the VS hospital, just eight cases of CDH are registered and none of the bilateral CDH, Dr Bhattacharjee pointed out.
The rarity of the disease is attributed to the high-risk it entails. "The patient usually dies within 6-8 hours." said Dr Bhattacharjee.
But Kamlesh's survival for one long month was said to be due to another defect.
Usually, when the abdominal contents are pushed back into abdomen, the "tight" muscles are unable to take on the pressure. But, a defect in his abdominal wall worked in his favour as less pressure was exerted on the lungs.
Dr Bhattacharjee suggested that periodic exmination of the foetus through sonography is mandatory to prevent still-born babies or deaths due to such congenital defects.
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