Mumbai: Narayana Health SRCC Children’s Hospital, Mumbai, successfully treated a rare, complex, life-threatening bleeding condition in a 10-month-old infant, where blood originating from the lungs mimicked gastrointestinal bleeding. The baby had been vomiting blood, and passing dark brown stools and had recorded four such episodes intermittently at the age of two months. When she was presented to the hospital with these conditions recently, a team of doctors led by Dr. Aditya Kulkarni, Consultant, Paediatric Gastroenterology and Hepatology, examined her. She was admitted for thorough evaluation and investigations.
The infant underwent a series of comprehensive evaluations including liver function tests and an upper GI endoscopy, which did not reveal any abnormalities. Suspecting Cow’s Milk Protein Allergy (CMPA), doctors advised a soy-based diet and dairy elimination, which led to a temporary resolution of symptoms.
A crucial breakthrough in the case came when the mother reported that the baby had repeated coughing episodes before vomiting blood. Pulmonologist Dr. Indu Khosla conducted a bronchoscopy and discovered a small swelling near the base of the tongue, along with traces of blood in the airways. An MRI scan identified this swelling as a thyroglossal cyst, while a CT pulmonary angiography revealed the actual source of the bleeding—a small cavity in the upper part of the left lung with an actively bleeding blood vessel.
Given the rarity and complexity of this condition, an intervention was meticulously planned. Interventional Radiologist Dr. Mounil Bhuta performed a delicate embolisation procedure to block the bleeding vessel in the lung. The minimally invasive procedure, conducted in the cath lab, successfully stopped the bleeding, ensuring a safe recovery for the infant.
Dr Aditya Kulkarni, Consultant- Paediatric Gastroenterology and Hepatology, Narayana Health SRCC Children’s Hospital said: “This was an extremely rare case that presented several challenges. The bleeding did not originate from the digestive tract, as was initially suspected. The child was swallowing blood from the airways, which led to the appearance of dark stools. Respiratory causes for blood vomiting are highly uncommon and required extensive investigation. Performing a delicate embolisation procedure in a baby of this age demanded precision and expertise.”
Following the procedure, the baby showed remarkable improvement and was discharged after a seven-day hospital stay. She has not reported any further episodes of coughing blood, marking a successful outcome of the intervention. “This case exemplifies the power of collaborative medicine. Our team of gastroenterologists, pulmonologists and interventional radiologists at Narayana Health SRCC Children’s Hospital worked together seamlessly to diagnose and treat a condition that could have had severe consequences if left undetected,” Dr Kulkarni stated.
Dr Zubin Pereira, Facility Director, Narayana Health SRCC Children’s Hospital said, “This case presented an extraordinary diagnostic challenge, the successful treatment of which was made possible through a multidisciplinary approach using advanced diagnostic techniques and minimally invasive intervention. This achievement underscores our dedication to excellence in paediatric healthcare and our mission to bring hope to families facing complex and critical medical conditions.”
