Bangalore : Fortis Hospital Bannerghatta treated a four-year-old girl who was battling for life for more than 3 months as she was suffering from a rare and complex medical condition- Portal Vein Thrombosis (blockage of the veins that carry blood to the liver from the intestines by a blood clot) alongwith Portal Hypertension (high blood pressure in the portal veins, often caused by liver disease) wherein the pressures in Portal Vein and veins of Esophagus are very high leading to frequent bleeding from the food pipe which is life-threatening. This primarily happens due to congenital deficiency of certain factors which normally prevent clotting in an individual.
Th patient was referred from a city-based hospital in Mysore to Fortis Bannerghatta. Upon admission at Fortis BG, she was in a critical condition. Upon intervention by Dr Yogesh Kumar Gupta, Consultant – Paediatrician and Intensivist, Fortis Hospital, Bannerghatta Road and his team, it was diagnosed that the child was suffering with a perforated oesophagus, (tear or hole in the oesophagal lining that can cause leakage) an enlarged spleen, infected chest cavity (mediastinitis) and Infected abdominal cavity (Peritonitis) with liver failure. Due to a perforated oesophagus and oesophagal bleeding, she was unable to eat for more than 2 months and was on IV fluids which led to severe malnutrition. She had previously undergone multiple endoscopic procedures in Mysore to ligate the bleeding veins, but unfortunately, her condition was deteriorating with each passing day.
Dr Yogesh Kumar Gupta, Consultant Paediatrician and Intensivist, Fortis Hospital, Bannerghatta Road, said, “Our primary challenge was to stabilize the patient’s critical condition. To combat the infection, we started her on the best possible antibiotics, as her blood, abdominal fluids and fluid from the lungs were growing Burkholderia cepacian – a rare and challenging bacterium known for its chronicity and resistance to treatment. Despite encountering a severe infection during the initial surgery to seal the ruptured oesophagus, we continued the antibiotic treatment while providing specialized nutrition intravenously. The complexity of the case was evident, and we navigated through all obstacles to provide the best care possible. It was like we would take one step ahead, and her body would take two steps back. Every day was a challenge for the entire treating team.”
Emphasizing the severity of the patient’s condition, Dr Gupta stated, “The patient experienced another episode of massive bleeding from the oesophagus. The critical state required immediate resuscitation and intervention. Although performing the surgery to address the underlying cause (an enlarged spleen) posed a significant challenge, we proceeded with the surgery due to the gravity of her condition. We successfully removed the spleen and inserted a feeding tube into the intestines to ensure adequate nutrition. This procedure, coupled with the careful management of her infection, marked a significant milestone in her treatment journey. It took almost 6 weeks for the fever to completely settle and the infection to clear from her system. It was all possible because of our expert team of intensivists, pediatric surgeons, infectious disease specialists, high-class nursing care, and support from the hospital management.”
The girl was fever-free for 5 days before discharge, and was taking food orally. Her condition remained stable during follow-up visits, and she is now gaining weight and leading a happy life which she always deserved.
Mr Akshay Oleti, Business Head, Fortis Hospitals, Bangalore said, “Treating this complex case was a tremendous achievement for our dedicated team of healthcare professionals at Fortis Hospital, Bannerghatta. With unwavering determination and expertise, we overcame numerous challenges to restore this four-year-old girl’s hope and gave her a new lease on life. The exceptional skills and meticulous treatment by Dr Yogesh Kumar Gupta and his team of doctors and nurses exemplified our commitment to delivering world-class healthcare services. We are immensely proud of this significant milestone and remain steadfast in our mission to provide the best possible care to our patients.”
