Pune doctors drain rare cyst from day-old baby’s lung

The team of paediatric surgeons at Motherhood Hospital in Kharadi that operated upon baby Ruchika.

The team of paediatric surgeons at Motherhood Hospital in Kharadi that operated upon baby Ruchika.  

Ruchika was born in December 2019 with a cyst that occurs only in two or three cases in one lakh live births

A paediatric surgical team in Pune has successfully performed a complex, life-saving surgery on a day-old baby who was detected with a rare cyst in her lungs while still in her mother’s womb.

A team of paediatric surgeons at Motherhood Hospital in Kharadi operated upon baby Ruchika (name changed) in December last year after the child was born with a congenital defect wherein a fluid-filled cyst had been formed in her lung cavity. According to hospital authorities, this kind of cyst occurs only in two or three cases in 1,00,000 live births.

“The baby girl, Ruchika, weighing 2.5 kg was successfully delivered on December 13, 2019. The child was immediately moved to the hospital’s neonatal intensive care unit as she was encountering difficulty in breathing and had to be given continuous positive airway pressure therapy to help her breathe,” said Dr. Tushar Parikh, chief neonatologist at Motherhood Hospital.

Once the baby was stabilised, a lung lobectomy was performed on the second day of birth by paediatric surgeons Dr. Pranav Jadhav and Dr. Kalpesh Patil. “The baby was discharged earlier this month and was in good health,” said Dr. Parikh.

Posing risk to heart

“The cyst in the left side of the lung was hampering the baby’s heart function by compressing it, and may have caused heart failure. The doctors helped the baby breathe freely by initially removing fluid from the cyst that was present in her left lung by an aspiration process and later by performing a lung lobectomy [surgery to remove one of the lobes of the lung] immediately after the first day of her birth,” said Dr. Rajeshwari Pawar, gynaecologist-obstetrician, Motherhood Hospital.

Dr. Pawar said the foetus was diagnosed to have a type 1 congenital cystic adenomatoid malformation (CCAM), which is a developmental defect involving a benign lung lesion that appears before birth as a cyst or mass in the chest. She said, “The cyst is also known as congenital pulmonary airway malformation. The macro cyst present on the left side of the baby’s lung affected the lung tissue, pressed the heart vessels and shifted the heart from its normal position, thereby occupying a lot of space in the chest. This type of CCAM occurs only in say two or three cases in 1,00,000 live births. If left untreated, it would have compromised on the growth of the child’s lung.”

Explaining the complexity of the operation, she said a decision was taken to aspirate the fluid from the cyst using a fine needle by means of a sonographic guided procedure which involved anaesthetising the foetus. “It was a delicate procedure which posed high risk to the life of the baby. However, the procedure was successful and substantial fluid from the cyst was removed. But the cyst recurred and the mother had to be continuously monitored every week by doctors,” said Dr. Pawar.

‘Stayed strong’

Thanking the doctors at Motherhood Hospital for performing the delicate surgery, Shalini (name changed), the baby’s mother, said: “When we came to know about the cyst that was present in the foetus, we were stunned. But we didn’t panic, and stayed strong as it wasn’t advisable for me to be under stress during my pregnancy. After getting discharged, we also went for follow-ups, and the baby is fine now.”

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Printable version | Feb 17, 2020 12:02:41 AM |

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