Dr (Prof) KLN Rao, Director of Pediatric Surgery, Paras Bliss Hospital Panchkula and leading pediatric surgeon of Tricity performed a complex surgery for Choledochal Cyst (congenital bile duct anomaly) at Paras Bliss Hospital Panchkula. The surgery was performed on a 4 yr old baby boy from Solan, Himachal Pradesh, who had signs of jaundice and itching all over the body for over a month.
Hitesh Sharma, the 4 yr old baby boy had signs and symptoms for over a month. He had jaundice and itching all over the body. Moreover he was also passing dark coloured urine. When the eye colour of the child changed to yellow and the urine became dark coloured, his parents panicked and decided to consult a specialist.
On consulting a local paediatrician and through an ultrasound it became clear that the pipe carrying secretions from the liver into intestines (bile ducts) were grossly dilated. The local paediatrician suggested that the Sharmas’ consult a specialised paediatrician for the same in a hospital capable to provide high end medical care to children. Post consulting a few relatives and well wishers, the parents took the quick decision to come to Panchkula to consult Dr (Prof) KLN Rao – Former HOD and Director at PGI Chandigarh – MCh in Pediatric Surgery.
According to Dr KLN Rao, “When we examined the patient and went through his reports, it became clear that there was an issue in his bile duct. The jaundice also clearly indicated the same. The liver function blood tests were grossly abnormal and we suggested an emergency MRI Test which confirmed the diagnosis of dilated bile ducts by birth (choledochal cyst).”
Dr Rao further states, “Some newborns with cysts have symptoms right away. Others have good bile flow at first, but they get symptoms soon after birth. Some children don’t have symptoms for a couple of years or longer. Some people live with a choledochal cyst for many years but don’t know about it because they don’t have symptoms until they are an adult. Babies or children with a choledochal cyst may have these symptoms: Yellow color to the eyes and skin (jaundice), Pain in the upper-right belly (upper-right-quadrant pain), Soft mass that can be felt in the upper-right belly, Pale or clay-colored stools (feces), Fever, if they have an infection (cholangitis). If they have an inflamed pancreas (pancreatitis): belly pain that may come and go, nausea and vomiting.”
Describing the issue Dr Rao highlights, “Choledochal (pronounced coal-ee-DOCK-uhl) cyst is a problem with the tubes (ducts) that carry bile from your child’s liver to their gallbladder and intestine. The tubes get bigger than normal (dilate) or pouches form on the tubes. This keeps bile from flowing well, which can cause liver problems. Cysts can block the flow of bile. When bile doesn’t flow well, the bile ducts can get swollen and irritated (inflamed) or infected. This is called cholangitis. Over time, it can cause scars in the liver (cirrhosis). Then the liver cannot work well. Children with choledochal cysts may also get an inflamed pancreas.”
In Hitesh’s case it was clear that the baby boy needed immediate pediatric surgery. During surgery the dilated bile duct (choledochal cyst) was removed from all the surrounding vital structures carefully. A fresh passage to drain the liver secretions (bile) from the liver into the intestines was created carefully, utilizing child’s own intestine. The surgery lasted 4 hours.
Post surgery the baby boy was kept under strict observation and on the 5th day his health improved significantly. He even celebrated his 5th birthday with the hospital staff.
Hitesh’s mother shares, “For us Dr Rao was God sent. From the time of the diagnosis, surgery, post operative care to discharge, he was more concerned about the baby than us. He even highlighted our negligence of ignoring our baby’s signs. Today he is healthy and leading a normal life. We think that Hitesh’s birthday celebration was a gift of life from the hospital and Dr Rao to him.”