A woman in the 31st week of pregnancy came in to Hillel Yaffe with early contractions. A fetal anatomy scan performed during her pregnancy due to excess amniotic fluid and an distended stomach, made the doctors strongly suspect that the fetus had a gastric outlet obstruction. However, the fetus continued to grow and develop in the womb. When the baby’s heartbeat slowed, the woman was rushed into an emergency c-section, and the baby was born in good condition and hospitalized in the NICU for continued care.
In an ultrasound of the digestive tract and imaging with a contrast agent, the doctors saw that the baby had a distended abdomen and that he had a complete gastric outlet obstruction. Dr. Michael Medvedev, a pediatric surgeon at Hillel Yaffe who examined the baby, decided to hold off on surgery until the baby reached at least 1.5 kg. After seeing that the baby was not gaining weight with total parenteral nutrition, Dr. Medvedev decided to operate on the baby despite his young age and low weight (1,400 grams).
From right to left: Dr. Sylvia Foldi, the mother and tiny baby Zuheir
In the surgery, which was performed together with Dr. Sylvia Foldi, a senior physician in the Newborn and Neonatal Care Department, they saw a thick partition, which blocked the outlet from the stomach to the intestine. Dr. Medvedev removed the partition, was able to remove the obstruction and successfully reconstruct anatomical completeness of the surgical area. Five days later, the baby began breastfeeding for the first time and even gained weight.
Dr. Medvedev noted that this was a very rare congenital defect. “The incidence of this is 1 in 100,000 births. It is important to understand that the moment a baby with a complete obstruction of the upper digestive tract is born, feeding is only done intravenously, as food and fluids cannot pass through, meaning that the baby cannot eat like a regular baby.”
According to Dr. Foldi, “Due to the high blockage and the fact that we were dealing with a premie, we were concerned that most of the digestive tract had not developed and matured as expected. Happily, after surgery, the premie is eating, absorbing the breastmilk well and gaining weight.”