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Mumbai: Surgery saves 12-year-old afflicted by rare condition

Updated on: 19 September,2017 11:22 AM IST  |  Mumbai
Vinod Kumar Menon | vinodm@mid-day.com

He was diagnosed with an aneurysmal dilation of the thoracoabdominal aorta, usually seen in people over age 40; underwent 10-hour surgery to resolve issue

Mumbai: Surgery saves 12-year-old afflicted by rare condition

Om Gupta with his parents and Dr Bipeenchandra Bhamre (seated)
Om Gupta with his parents and Dr Bipeenchandra Bhamre (seated)


What began with a schoolboy complaining of constant headaches for the past six months, ended with the diagnosis and treatment of what not only shocked treating doctors but the entire medical fraternity. He was suffering from a condition seen in adults, and very rarely seen in children.


Om Gupta, 12, a class VI student, stays with his parents Durgaprasad, 36, mother Nisha, 33, and three sisters in an Andheri East society. When his headaches were not treated by routine pain killers and medication, his worried parents admitted him to Holy Spirit hospital. Durgaprasad, a truck driver, who hardly earns R10,000 a month, said, "The doctors admitted him to the ICU and carried out MRI/CT scans. Later they advised us to approach bigger hospitals."


"We tried almost all the major hospitals including Wadia and KEM, where doctors informed that they do not perform such complicated surgeries on children. We were finally referred to the H N Reliance Foundation and Research Centre," said Durgaprasad.

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The diagnosis
Dr Bipeenchandra Bhamre, cardio thoracic surgeon at the hospital said they were concerned about Om's abnormally high blood pressure in the upper body - 200/120 mmHg, whereas in the legs it showed at 90/70 mmHg. "A series of tests later confirmed that he had a rare, seldom seen case in children - aneurysmal dilation of the thoracoabdominal aorta. The headache was because of the high blood pressure in the upper part of the body. There was also reduced flow to the stomach and lower limbs."

An aneurysmal dilation of the thoracoabdominal aorta means a weakening of the wall of the aorta, the great artery of the body, which causes it to expand like a balloon, which could rupture any moment. "This condition mainly affects adults beyond 40 years of age. It is very unusual to see this disease at 12 years of age," Bhamre said.

"In the USA I had come across few such complicated surgeries. On a 12-year-old, this surgery is probably the first in Mumbai," Bhamre added.

After explaining to Om's parents the risk involved, it was decided to operate in the second week of August.

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The surgery
"We had opened the left side of the chest and midline of the stomach through a single large incision. About 30 cm of the aorta was replaced with polyester graft. The blood vessels to the kidneys were implanted into the tube graft.

The blood vessels supplying blood to the small and large intestine as well as blood vessels supplying to the liver and spleen were also implanted into the graft. All this had to be done by stopping the blood supply passing through the spinal chord to the lower part of the body, within seven to eight minutes. And any delay in doing this would have led to permanent damage to liver, kidney etc." said Dr Bhamre about the risky surgery.

What led to the ailment
Dr Bhamre is of the belief that Om had Giant-cell Arteritis (GCA), an inflammatory disease of blood vessels. The exact cause of this disease is not fully understood, although it is thought to be an autoimmune disease that occurs when the body's own immune system attacks the healthy tissue.

The cost
According to Dr Bhamre, such a major surgery would cost nothing less than R8-10 lakh. "I could only collect R2 lakh from charitable trusts and the CM's Relief Fund. The balance money was taken care of by Reliance Foundation," said Durgaprasad.

Om is still under medication. He is also not yet allowed to play with his friends, as his parents fear that over exertion may tire him or even lead to complications.

Durgaprasad said, "Definitely, not a truck driver. I want him to study, as much as he wants and be grateful to the doctors, who gave him a new lease on life."

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Surgery

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