Today we had an interesting case of a very ill neonate. The patient showed up three hours old after being born at a private hospital. The baby boy had respiratory distress after birth and had an ultrasound and X-ray showing a congenital diaphragmatic hernia. He was then transferred as the private hospital did not have the specialty services needed to care for him. On arrival to GPHC, the neonate was noted to have blue hands and feet, due to poor oxygen levels. Due to the hernia, his intestines were present in his chest causing compression of the lung, preventing adequate breathing.

hernia x-ray

The baby was present with his father and aunt, as his mother remained at the private hospital after giving birth. After discussing the severity of the situation to the baby boy, a breathing tube was placed to protect the infant’s breathing and to improve oxygen delivery to his body. His color fairly quickly improved from blue to pink- a very encouraging sign. We called for the pediatric surgery team, and fortunately GPHC had a team present from the International Children’s Heart Foundation. The baby was admitted with the hope that he could be stabilized enough to undergo a surgery to correct his hernia and have a chance at life.

About a week later I was walking down the road after my shift when I heard “doctor, doctor!” I looked over to see this infant’s Aunt, she had pulled over to the side of the road while driving by. She was eager to tell me that he had undergone corrective surgery, had a diaphragm repair with mesh, and that he seemed to be recovering well. The surgery is by no means a definitive fix, as he will need repeated surgery as he grows, but the family was very hopeful for his future. She was very appreciative of the care provided in the A&E. It was incredible that this baby was able to undergo such a complex surgery in a country that still has a developing healthcare system.