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Surgery cures rare foodpipe narrowing

When little Anurag started throwing up any solid food his mother tried to feed him, the Dhar household as well as the family physician dismissed it as routine indigestion. But the vomiting persisted and the five-month-old boy failed to gain any weight over a period of time. “He simply refused to accept any food and was surviving only on milk,” Anurag’s mother recalls.

His father, Sukanta Dhar, a businessman in north Bengal’s Naxalbari, finally brought the child to Bhagirathi Neotia Woman & Child Care Centre last month. The boy, now all of nine months, was diagnosed with ‘oesophageal stenosis’, “an extremely rare condition”, which was corrected by a marathon, complex surgery.

“There was a constriction near the middle-third of the child’s oesophagus, which led to a narrowing of the foodpipe,” explains paediatric surgeon Partha Pratim Gupta, department head, Institute of Child Health, Calcutta, who treated Anurag.

“Oesophageal stenosis is very, very rare — just one in 100,000 live births — and is extremely difficult to diagnose, particularly immediately after birth, since milk and liquids can pass through the narrowing. Once the child is weaned onto semi-solid and solid food, the problem starts, since the patient can’t swallow the food and throws up everything,” Gupta observes.

When Anurag was brought to the Rawdon Street hospital, an X-ray of his oesophagus revealed a huge dilatation of the foodpipe along the stenotic part. Gupta, also professor of paediatric surgery and overseas college tutor of Royal College of Surgeons of Edinburgh, and his team prepared the child for a major operation that entailed getting into the chest cavity and working behind the heart. The stenotic part of the oesophagus (about 1.5 cm long) was removed and continuity was re-established.

Anurag was discharged after a week and is now gradually being weaned onto a solid diet. “He is not vomiting any more,” smiles father Sukanta.

The condition, concur doctors at the mother-and-child hospital, is very difficult to diagnose and if undetected for long, causes food to spill over to the windpipe, causing ‘recurrent aspiration pneumonia’. “Doctors then go on treating the pneumonia, which leads to associated complications,” stresses Gupta.

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