Doctors remove 8-kilo hernia from baby's skull

When Shwetang was brought to the neurosurgery department of AIIMS, he was two-and-a-half-month old and weighed 11 kilogram.

The 8 kilogram of extra weight was on account of encephalocoele, a disease commonly known as hernia. The disease occurs in four out of every 1,000 live births.

He was operated at All India Institute of Medical Sciences on January 23 by a team of doctors, anaesthetists and nurses. Following his recovery, he is going back to his hometown Siwan, Bihar, on Thursday.

“We called this a case of extra giant encephalocoele because of the humungous size of the swelling,” said Dr A K Mahapatra, head, neurosurgery, AIIMS.

The circumference of the head was 80 cm, which reduced to 39 cm after surgery.

“The mother brought the child to us in a tub because she was not able to hold him. To the best of our knowledge, such extra giant encephalocoele has never been reported,” said the doctors.

Shwetang was born with a swelling the size of a lemon.

“As the size kept increasing, it became difficult for me to even breast-feed my first baby,” said Sushma, Shwetang’s mother.

He could not sleep due to discomfort in turning the body.

“The surgery should be done under proper circumstances in hospitals where there are facilities of anaesthesia, body warming blankets, incubators and ICU. Even in 40 degree Centigrade, the baby has to be kept warm due to heavy loss of blood,” said Dr Mahapatra.

He said it was relatively easy to conduct the surgery because his swelling largely had cerebrospinal fluid and not other parts of the brain.

“In cases where a part of brain also comes out of the skull, we can’t reduce the swelling completely,” said Dr Mahapatra.

The doctors said encephalocoele occurs due to nutritional deficiency, measles and radiation among pregnant women. Genes are also one reason.

“One has to be very careful with post-operative care of such children. Their temperature has to be monitored as loss of more than 100 ml of blood is tough for a young body to take. The CSF has also to be replaced meticulously,” said Dr Vivek Tandon, assistant professor, neurosurgery, AIIMS.

The doctors emphasised such children are not ‘monsters’, as believed by many superstitious people in society.

“They just need proper treatment,” they said.

But troubles don’t end here for Shwetang. Bone from the back of his head was removed for the surgery. “We have asked the mother to be careful that he does not fall, especially not backwards as it can damage his brain,” said Dr Mahapatra.

After more than a year, he will undergo another surgery for an artificial bone.

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