A tiring day at work had just ended and we were looking forward to getting some rest. But the Emergency Room was still busy and Dr Sushil was on-call, managing the patients.
22-month-old Babu* was brought in with a painful swelling in his right groin and a few episodes of vomiting. He was in agony and wouldn’t let anyone touch him. I was called in and upon examining, found that it was an obstructed inguinal hernia. An erect abdominal X-Ray showed multiple air-fluid levels.
It had already been four hours since the swelling appeared and his crying was making the obstruction worse. He needed an emergency surgery or else the entrapped bowel wouldn’t survive and his life could be in danger too. The parents were horrified that such a small child had to undergo surgery, but it had to be done.
Dr Sushil accompanied me to the Operating Theatre where another challenge was awaiting us: General Anaesthesia. Intubating a small child can often be difficult and with a limited time frame the pressure intensifies. However, with combined effort of the surgical and anaesthesia team, we were successful.
At surgery we found a loop of small bowel was ischaemic**. After releasing the bowel and applying hot mops for some time, the colour changed from greyishblack to pink and we could see peristalsis returning. Thankfully the bowel didn’t need resection. It was reduced back into the abdominal cavity and the hernial opening was closed off.
The post-operative period was uneventful and Babu started being playful again. After seven days in the hospital, it was time for him to bid us goodbye. His parents were thankful to us and to the hospital for saving the life of their son.
Hospitals in Kathmandu are an option for some well-off families but when time is of the essence and finance is a constraint OCH still stands tall, taking away pain and giving back smiles to everyone who knocks at its door.
* Name changed
** Had a restricted blood supply.
BIJAYA LAXMI GURUNG
General Sugeon
