AIIMS surgeons remove 8-kg hernia from 2-month-old`s head

New Delhi: It was a miracle for the Pandey family from Bihar as doctors at the All India Institute of Medical Sciences (AIIMS) saved their two-month-old baby`s life, removing from his head an 8-kg fluid-filled hernia, considered to be the largest so far.

The family had lost all hope after being told by doctors back home to "abandon" Shwetang as he suffered from a life-threatening hernia that hung from his tiny skull.

Shwetang was brought to the premier health institute in a tub as the mother could not hold the 11-kg baby who had a huge sac-like structure hanging from the back of his head.

"When the baby was brought to us, a huge hernia hung at the back of his head. He weighed 11 kg and we decided to conduct a surgery inspite of the long waiting list we have at AIIMS. Nearly six litres of fluid was drained from the baby`s hernia that hung from the baby`s skull," A.K. Mahapatra, head of the neurosurgery department at AIIMS, said Wednesday.

Weighing 3 kg after the surgery, Shwetang is healthy and recovering now.

Mahapatra and a team of doctors performed the two-hour long surgery Jan 23.

Life was not easy for Shwetang and his family back home in Siwan district in north Bihar. The family was told by local doctors to abandon the baby because "there was no scope for development of the baby`s brain". But the family did not give up.

"Some said the baby has two heads, some said it is god`s gift. We were initially apprehensive about the surgery, but doctors gave us strength," said his relieved mother Sushma.

Known as encephalocele, the baby`s condition resulted due to a malformation in the skull by birth. The hernia`s fluid containing protein, fat, and sugar was collected through a suction pipe. Doctors say it was a case of "giant encephalocele".

"Nowhere in the world we have seen such a giant encephalocele and that too on such a small baby. This is the largest hernia so far," Mahapatra said.

The baby was born with a lemon-size swelling at the back of his head. The 10-cm swelling grew into 80 cm swelling within two months of the birth.

"Thankfully, the brain had too little a portion in the hernia. Otherwise it would have been very difficult to remove the hernia," Mahapatra added.

The surgery was a hard battle fought by the AIIMS doctors who felt the blood loss and controlling the body temperature were a major challenge. Death is a possibility of the case, pre- or post-surgery.

"The child was too small. Children have a small blood volume, and even little blood loss during the surgery could have been fatal," said Vivek Tandon, assistant professor at the neurosurgery department.

Some of the causes of the condition, according to doctors, are nutritional deficiency during pregnancy, mother`s exposure to radiation, or genetic factor.


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