“Ziyad was born last year on October 24 in Jalna (Maharashtra). He was born normal, but two months later, he started coughing continuously. Initially, we thought it was a normal cough and cold, but when he started breathing heavily, we were worried,” said Yusuf Yunus, Ziyad’s father.
Ziyad’s X-ray reports came as a shock to Yunus. It revealed that Ziyad was suffering from a rare disease called Bilateral Morgagni Hernia, wherein a hole is developed in diaphragm- muscular sheet which separates organs within the abdomen from the chest. The diaphragm is a dome-shaped muscular partition separating the thorax from abdomen in mammals, which plays a major role in breathing.
Yunus, who resides in Trombay and is a teacher at Govandi’s Municipal School, immediately began the treatment for Ziyad. Two-and-a-half-months-old Ziyad is Yunus’s second child.
Ziyad’s breathing rate was 1.5 times more, which is abnormal for a toddler. The initial X-ray reports revealed that his large intestine was in the chest. He had holes on both sides of the diaphragm, which is extremely rare, along with most of the left side of the liver, and some right lobe of liver was in chest, making it difficult for him to breathe.
Dr Rajesh Nathani, Consultant Paediatric Surgeon and Paediatric Urologist, Zen Hospital, who treated Ziyad, said, “There are very few such cases in the world, there was only one such case in India, but which affected only one side of the diaphragm. However, in this case there were holes on both sides of the diaphragm, making it a rare case.”
A successful 3D laparoscopy surgery was conducted at Zen Hospital in Mulund.
Explaining the surgery, Nathani said the liver was first brought back into the abdomen.
“The holes were identified, from within which the bare, beating heart could be seen. To cover this defect, a large mesh was placed within Ziyad’s chest,” he added.
Dr Ravindra Ramadwar, Consultant Paediatric Surgeon and Laparoscopic Surgeon at Zen Hospital, who has witnessed third such case so far, said usage of mesh to repair hole is uncommon.
“In last 26 years of my medical career, this is third such incident which I have witnessed. The first was in 2001 and second in 2007. Using a mesh in babies is extremely rare. This type of rare anterior defect of diaphragm is variably referred to as morgagni, retrosternal, or parasternal hernia, accounting for approximately 2% of all congenital diaphragmatic hernia cases,” said Ramadwar.
Talking about reasons in such cases, Ramadwar said, “There is no specific reason. The development of diaphragm happens from multiple parts in the body so the central portion did not develop. The main part of diaphragm in the child’s central part did not develop at all so there was large hole in the muscle.”
Ziyad was discharged on January 27.
“We are very much thankful to God and the doctors who treated my son. There are no other health issues now, he is breathing properly,” said Yunus.