In a first for Indian hospital, Tanzanian teen with rare disorder undergoes high risk surgery

Friday June 15 2018

 

By The Citizen Reporter news@tz.nationmedia.com

A 19-year-old Tanzanian girl from Zanzibar has gone through surgery at SIMS hospital in Chennai, India for a a rare congenital defect that left her with a bloated stomach. Reports from Indian news outlets, The Hindu and New Indian Express, indicate that Ms Sauda Suleiman Amour was diagnosed as suffering from omphalocele, a condition where the abdomen wall that protects organs such as intestines and liver is thin. 

New Indian Express further explains that the condition causes an infant’s abdominal organs, including intestine to protrude outside the body because of a hole in the navel area. In Amour’s case, even the liver was pushed outside. “The patient’s family brought her to the hospital. We wanted to put the liver back into the abdomen, but there was little space,” the doctors added.

On their Facebook account, SIMS Hospital said that this was India’s first hepatomphalocele repair surgery at the hospital. 

The news reports by New Indian Express indicate that Ms Amour had dropped out of school four years ago and was bullied for her bloated stomach since people thought she was pregnant. 

The Hindu voiced  Radhakrishna Patta, Director and Senior Consultant, Surgical Gastroenterology  of the hospital, who performed a four-hour surgery on her, who said that Ms Amour was a beneficiary of a recent agreement between the hospital and the Tanzanian government. The medical board in Tanzania gave the clearance, and she was admitted to the hospital three weeks ago.

“Just a thin sheet of skin was covering the protruding organs. Usually, within a month or so after the birth, the skin of the infant grows and covers the organs. However, in Amour’s case, it did not happen. Any injury to her abdomen would have cost her life,” said Patta to New Indian Express.

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Since the abdominal wall had thinned out, doctors had to reconstruct it. Doctors created space in the abdomen to accommodate the liver and intestines and used a method called transversus abdominis release (TAR), continues The Hindu’s report. “We use a mesh to give strength to the muscles and prevent hernia,” Dr. Patta said.

Furthermore, K. Raghavendran, Director of anaesthesia and pain management, said, “Creating a large space in the abdomen was a challenge. We used Botox injections to relax the abdominal muscles.”

Ms. Amour will be discharged on Friday. Chairman of SRM group Ravi Patchamuthoo said the hospital’s team of skilled and experienced surgeons performed latest gastrosurgical techinques.

Furthermore, New Indian Express explained that doctors in Tanzania performed the surgery unsuccessfully when the patient was five years old. “This is the first case where the surgery was performed at this age. The patient’s family brought her to the hospital. We wanted to put the liver back into the abdomen, but there was little space,” the doctors added.

“To enlarge the abdomen, we injected a litre of air into it through a fine tube over two weeks till the abdomen muscles enlarged. This procedure is called pre-operative pneumoperitoneum. Botox injection was also used to relax the muscles,” Patta said to New Indian Express.

The organs were put back and the abdomen was closed. The surgery was performed two week ago and she is ready to go home. “In spite of extensive search in medical literature we have not come across any other similar case of hepat omphalocele-liver in omphalocele in the world,” doctors said.