Successful Treatment Of Mesenchymal Tumor In a Three Year Old Child Through Right Hepatectomy Surgery @Chandan Hospital

Tumor can occur at any age and recently at Chandan Hospital, Dr Alankar (Director, Chandan Institute of Gastro-liver & Billary Sciences) diagnosed baby Ananya of three years with Mesenchymal tumor in the right lobe of the liver. It is a rare tumor occurrence in the liver for a child of her age. Typically, the cells grow, divide and replace one another with new cells forming old cells die in a healthy body. When a person has a tumor, it is when several new cells or an accumulation of cells can develop.

Tumor is an abnormal increase in resulting in excess of cell growth into a mass of tissue, which seems like swelling. The official definition of the tumor by the National Cancer Institute is, “an abnormal mass of tissue that results when cells divide more than they should or do not die when they should.”

Let’s understand the kind of tumors that exist, their diagnosis and approach of treatment differ in patients depending on its kind.

Kinds of Tumor:

Tumors appear on the body in numerous sizes ranging from a small nodule to a huge mass depending on the kind of tumor it is. Tumors can occur on any part of the body. Below are mentioned the three kinds of Tumors are found:

  • Benign: The benign tumors are not cancerous, and they do not spread or grow (even if they do that, they do that very slowly). Doctors can easily remove it, and they usually do not return. They might not be harmful but can affect other parts of the body by causing pain, pressing against a blood vessel or a nerve, and triggering overproduction of hormones. Example of benign tumors are adenomas, fibroids, hemangiomas, and lipomas.
  • Premalignant: The premalignant tumors suggest that tumor cells are not yet cancerous but have the capability to become malignant. Therefore, it is required to monitor its growth. Example of premalignant tumors are actinic keratosis, cervical dysplasia, metaplasia of the lung, and leukoplakia.
  • Malignant: The malignant tumors are cancerous as it can grow and spread to other parts of the body. They can grow at a higher rate spreading to other parts, and this process is known as metastasis. It is a life-threatening condition, and they begin to invade other body parts of the body as well. Example of malignant tumors are carcinoma, sarcoma, germ cell tumor and blastoma.

Still, it is never absolutely known the reaction of a tumor as even the benign one can turn into premalignant and then malignant. It becomes essential to check in case there is any growth.

Tumour Diagnosis:

At times a person might feel or see a tumor and a few people have to get it diagnosed through imaging test like MRI & mammogram etc. These tests can only detect a lump if present. Biopsy of the lump becomes essential to find out what kind of lump it is. For the biopsy, the doctor collects a tiny tissue sample and send it to technicians to further examine it with a microscope. The doctor collects the sample during the surgery or at his office. There is a requirement of surgery in cases where the tumor is found to be malignant, or it is pressing a nerve or causing pain.

The above information provides an overview of a tumor, its kinds and diagnosis process. She came to the hospital with persistent pain in her abdominal region and frequent vomiting. She met with Dr Alankar, and after a brief examination, he suggested her to take a few tests. After the test, he concluded that she had a mesenchymal tumor in the right lobe of the liver. The mesenchymal tumor is a benign presenting with numerous clinical signs & symptoms. Its diagnosis can be achieved by radiology and histopathology. For long term satisfaction and in most cases, it is adequate for curative purposes to opt liver resection.

The diagnosis of baby Ananya of having a tumor in the right lobe of the liver at such a tender age required with pain and other symptoms Dr Alankar suggested her parents for right hepatectomy (pediatric) procedure. She was admitted on 27th September for the operation at Chandan Hospital. The team operating her comprised of Dr Alankar as a surgeon, Dr Khalid (Sr Consultant, Chandan Institute of General Surgery) as an assistant surgeon, Dr Himangi (Consultant, Intensivist & Anaesthetist) as a paediatric anaesthetist, Dr Narendra (Director, Chandan Institute of Paediatric & Neonatology) as a Paediatric Intensivist, and Dr Rohit Agarwal as an interventional radiologist.

Typically, experienced surgeons perform liver resections as it is a high-risk procedure. With the advancement in the field of medicine, the experts assure enhanced care during the surgery, understand the anatomy of the liver entirely, and the technological progress has advanced the patient care aspect. Without prior liver mobilization, the anterior approach of right hepatectomy is a trusted technique. Although, in hepatectomy procedure, blood loss control is essential as exorbitant loss of blood and transfusion of blood in patients are correlated to postoperative risen rates of mortality and endangered to prolonged oncological consequences. The team performed the procedure of right hepatectomy on baby Ananya keeping all the above points into consideration. Her surgery was a success with minimal blood loss. She was discharged after observing her recover swiftly on the fifth day after the surgery on 1st October.

Patient Testimonial:

I was in a lot of pain, and my parents were worried about me. They took me to Chandan hospital Lucknow, and Dr Alankar operated me. After the discharge, my health started recovering, and the pain subsided in the abdominal region. I am thankful to the doctors and team Chandan for taking care of me.

Doctors Assessment:

The patient came in here with an issue of persisting pain in the abdominal region, vomiting and low body weight. She was of merely three years old, and after a few tests, it was clear that she had a mesenchymal tumor in the right lobe of her liver. I advised her parents for her to go through the right hepatectomy procedure. This procedure would relieve her of the constant pain. During her follow up after the surgery, she had gained a little weight and was looking better after the checkup.

Severe Road Accident Injury in Liver Operated with Laparoscopic Left Lateral Hepatectomy @ Chandan

Accidental injuries can occur at home or outside that too at times it is so grave that you need to go through a series of procedures and medication to reach normalcy. The term “accidental injuries” is itself indicates that it is all kinds of injuries that occur due to an abrupt, unexpected and ill-fated incident. It can be burns, bites, falls, road accidents, drowning, falls and stings etc. For instance, you can fall from stairs injuring your back or slipped and hit a sturdy object causing internal or external bleeding. Such incidents are traumatic and fatal to some. At times incidents such as an accident while enjoying an adventurous activity of sports or drunk driving are also a few examples when accidents occur.

Accidents are an unforeseen incident that can occur at any time and is one of the frightening causes of demise. Any person, who suffers grave physical harm or damage inflicted due to an accident causing an overwhelming outcome affecting his/her life in numerous contexts such as physical pain, emotional trauma and financial crisis.

Road accidents result in slight injuries to gruesome injuries to life-threatening cases are observed. Mostly such accidental cases with injuries are rushed to a closest possible emergency available. Emergency departments in hospitals are equipped to deal with such incidents at hand. Such a case of road accident was rushed to Chandan Hospital Emergency (ER) of a young boy, Sunny a B. Pharma student of Babu Banarsi Das, who was in a state of shock when admitted. He was seriously injured in the road accident, which caused him a blunt trauma in the abdominal region & liver laceration.

His case was transferred to Dr Alankar, Department of Gastro-Liver & Biliary Sciences. Dr Alankar accessed the condition of the boy and advised him to go through “laparoscopic left lateral hepatectomy”.

Laparoscopic surgeries are also known as MIS (minimally invasive surgery) or keyhole surgery. This kind of surgery enables the surgeon to reach inside the abdominal wall without a requirement of a larger incision. An instrument smaller in size used during a laparoscopic procedure is called laparoscope. It is a small tube with a camera and a source of light providing the surgeon images of the inside on a television monitor. It is one of the most opted surgery as through this swift recovery is possible. Hepatectomy is a surgical procedure to remove whole or partial parts of the liver, which is termed as resection.

Dr Alankar performed the laparoscopic left lateral hepatectomy, which was performed under general anaesthesia. The patient was asleep during the entire procedure and did not feel even the slightest pain. Very minute incisions are made in the abdomen wall through which Dr Alankar gained access through laparotomy to the organ. The procedure was successful and the patient was admitted for ten more days to be observed. During his stay in the hospital, his condition recovered and was discharged in a healthy condition, with advice to be on bed rest for at least ten more days. The patient is currently back to his home town Delhi with his parents.

Patient Testimonial:

I met with an accident on Faizabad road and was rushed to the nearby emergency of Chandan Hospital. The accident happened suddenly and I can only recollect the exact incident in bits. It was a horrifying moment as soon as I was hit, I could only remember the bleeding and intense pain in the abdominal region. I passed out due to the intense pain and when I gained consciousness I was under primary care in the ER. As my wounds were very serious, I was transferred to Dr Alankar for consultation and assessment. As my liver was hurt, he suggested for laparoscopic left lateral hepatectomy. I went under the procedure and recovered swiftly. The staff at Chandan hospital was caring and I am grateful to Dr Alankar.

Doctors Assessment:

The patient was in intense trauma and seriously injured when he reached the Emergency at Chandan Hospital Lucknow. I was called to assess the patient’s condition as he had blunt abdominal trauma & liver laceration. To heal him from the internal injury in the liver, I recommended laparoscopic left lateral hepatectomy. It was a minimally invasive surgery and the patient swiftly recovered within the ten days of hospital stay to be observed.