According to the doctors, Bambam Kumar Mandal, a construction worker in Airoli, had come to the hospital last month (March 16) with severe pain in his chest and shortness of breath.
A 27-year-old man's heart was in his mouth when doctors at JJ hospital told him that his entire stomach, spleen and intestines, had got relocated to the heart cavity. According to the doctors, Bambam Kumar Mandal, a construction worker in Airoli, had come to the hospital last month (March 16) with severe pain in his chest and shortness of breath.
"The chest X-ray showed a gastric bubble. CT scan and other investigations revealed that Mandal was one of the few cases in the world suffering from Bochdalek hernia. So far, medical literature shows only 173 such cases," said Dr Ajay Bhandarwar, professor of JJ hospital's surgery department.
Explaining the defect, assistant professor in the surgery department Dr Amol Wagh said Bochdalek's hernia results from failure of normal development of the diaphragm. "It is a congenital defect that wasn't detected till now. In Mandal's case, the CT scan showed a 6.8cm opening in the diaphragm because of which these organs, over a period of time, entered the chest cavity, thereby compressing the lung. It also led to displacing the heart to the right side," said Wagh.
Mandal was operated on the next day, on March 17, said doctors. In the three-hour-long surgery, the doctors used laparoscopy to bring these organs back to the abdominal cavity. "We decided to go for a minimally invasive surgery... combining laproscopy and thoraoscopy, we made six holes — three in the lung region and three in the abdomen region — through which the lapascropic devices were inserted. Among the 173 reported cases, only one was operated in such a way. Mandal is the second," said Wagh. He added that during the surgery, they found that the stomach had twisted, resulting in frequent vomiting.
The doctors not only arranged for the free surgery and the equipment but also his tickets to return to his native place in Bihar. "He didn't have any relative with him. Because he didn't have enough money either, we decided to get the required instruments for the surgery for free from the vendors," said Wagh.
Doctors said as he was hepatitis-B positive, the instruments weren't reuseable. The total instrument cost came to Rs1 lakh.
Though Mandal was free to be discharged three days after the surgery, the hospital decided to keep him for a month to finish his follow-up. "It was a complex surgery. We didn't want him to miss the follow-up," said Bhandarwar.
For Mandal, these doctors have assumed god-like importance. "They gave me a second lease of life... I used to work at a construction site in Airoli and my employer hasn't paid me yet. My family can't afford my treatment. So, I feel lucky to have come to JJ hospital; they arranged for everything — a free surgery and return tickets," he said.
Pursuing his BA (history), Mandal is positive of completing his education once he's home and getting a decent job.
Appluading JJ hospital doctors, head of the surgery department at KEM hospital Dr AK Gwalani said, "This highlights that a condition requiring an open surgery can be done laproscopically."
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