Premature baby suffering from rare forceful vomiting saved in timely surgery

Posted on 19-11-2022

Babies with this condition may seem hungry all the time, but a physical investigation followed up by an ultrasound of the abdomen would confirm the diagnosis

Doctors at a hospital in Dubai have successfully offered treatment to a late preterm infant born with pyloric stenosis — a rare condition that blocks food from entering the small intestine and causes forceful vomiting and dehydration.

For expats Gunel Jeiranova and Orkhan Kazimli, becoming new parents didn’t go according to plan.

Baby Alikhan, their bundle of joy, came into their lives this August 10, at 36 weeks of gestation, considered a late preterm. He weighed 2.87kg after a normal delivery at a private hospital in Dubai.

Gunel, a 25-year-old homemaker from Georgia, recollected how Alikhan fell sick, couldn’t pass stool and had trouble having his feed.

“We took him to the paediatrician at the same hospital where he was delivered. The doctor diagnosed him with pyloric stenosis. It’s the tightening of the muscle causing the blockage between the stomach and small intestine,” she said.

On September 1, little Alikhan was rushed to NMC Royal Hospital at Dubai Investments Park and examined by a team of doctors led by Dr Venkatesh Annigeri, consultant paediatrics surgeon.

Dr Mukul Mangla, a neonatologist, noted that the intestine blockage caused dehydration, multiple vomiting episodes, and intolerance of feeds, which resulted in weight loss.

“We had to urgently correct his fluid imbalance and address the metabolic changes.”

Once Alikhan became stable, the doctors planned for surgery to remove the muscle stenosis between his stomach and the small intestine.

What is pyloric stenosis?

Dr Annigeri explained that pyloric stenosis is a congenital disorder, a birth defect that occurs in the first month of a baby’s life and requires immediate treatment.

“The narrowing of the pylorus due to concentric muscular hypertrophy causes gastric outlet obstruction with progressive vomiting that leads to malnutrition, dehydration, and severe metabolic disorders. Prompt diagnosis and surgical intervention will prevent complications and reduce morbidity.”

Babies with pyloric stenosis may seem to be hungry all the time. But a physical investigation followed up by an ultrasound of the abdomen would confirm the diagnosis.

Dr Annigeri pointed out that the cause of this congenital disability, with a low occurrence of less than 1 per cent, is unknown and cannot be predicted.

“It doesn’t have any bearing on future pregnancies. The best treatment option is to operate on the child as soon as possible with a procedure called Ramstedt's pyloromyotomy – a specialised surgery done for pyloric stenosis. In this surgery, we cut only through the outside layer of the thickened pylorus muscle, allowing the inner lining to bulge out. This opens a channel for food to pass through to the small intestine making it like the usual gateway. We operated through a single incision minimally invasive surgery route and Alikhan’s surgery, conducted on September 3, took about 45 minutes.”

Doctors said the post-surgery recovery was excellent, and the baby got discharged on September 6. He was doing well on the follow-up and started gaining weight.

Gunel expressed her deep gratitude to the medical staff.

“They worked hard for my precious little Alikhan to get back home happy and healthy,” she added.

Doctors pointed out that an infant should be taken to a paediatrician if symptoms include forceful vomiting, sickness and failure to take feeds or deliver motions. This kind of vomiting differs from a ‘wet burp’ that a baby may have at the end of a feeding.