Mumbai News: 2-Year-Old Baby Becomes City’s First To Undergo Scarless PREM Surgery For Hirschsprung’s Disease At Gleneagles Hospital
Mumbai: For the first time in Mumbai, a baby who couldn’t pass stool for two years due to a rare Hirschsprung’s disease, was successfully treated through scarless endoscopic procedure.
A Nashik-based couple was overjoyed with the birth of their first child. However, after he turned one month old, they began noticing that he was struggling with severe constipation, which soon became a constant cause of concern. He was unable to pass stool for as long as eight days.
Despite multiple medications and daily enemas given by the family doctor, his condition never improved. His tummy often swelled with gas, and his weight gain remained poor.
The family travelled from Nashik to Mumbai in December 2024 and consulted Dr Vibhor Borkar, a paediatric gastroenterologist at Parel-based Gleneagles Hospitals, who suspected Hirschsprung’s disease.
A few diagnostic tests like barium enema, endoscopy biopsy, and manometry confirmed the condition. The disease affects one in 5,000 to 10,000 children and leads to severe constipation.
According to doctors, Hirschsprung’s disease occurs when nerve cells in the lower part of the large intestine fail to develop, causing stool to accumulate, causing blockage and leading to chronic constipation. There is no medical management for this condition, and it can even become life-threatening due to infections.
In very young babies, delayed passage of meconium can be an early sign. Older children usually suffer from swollen stomachs, vomiting, poor weight gain, and constant constipation while some may suffer from infections.
In a remarkable medical procedure, the baby became Mumbai’s first patient to be treated through a scarless endoscopic procedure called Per-Rectal Endoscopic Myotomy (PREM) at Gleneagles Hospital. The child, who had been solely dependent on daily enemas for over two years, is now leading a normal life after the procedure.
Dr Borkar said “Standard treatment requires major surgery that is either open or laparoscopic where the affected part of the intestine is removed and rejoined. However, in this child’s case, we used a minimally invasive technique called PREM, which avoids any external scarring. The child is free of symptoms, eating well, and passing stools without the requirement of enema. Not treating the child at the right time could have led to complications like enterocolitis, infection, and poor weight gain. Though this is a congenital condition, antenatal diagnosis is extremely difficult and the child becomes symptomatic after birth only.”
Dr. Shankar Zanwar, interventional gastroenterologist, said, “As the procedure is done endoscopically no scar or cut is seen on the body surface and the patient is pain-free after the procedure. Globally, only 13 such procedures have been reported, and this is the first case to be treated by the endoscopic method in the city of Mumbai. Everything was done internally through an endoscope and there were no cuts or stitches outside. Within two days, the child was discharged and no longer needed enemas.”
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