Jaipur: Surgeons at SMS Hospital Saturday said they had cured a rare condition in an 11-year-old boy, whose liver, gallbladder, and a significant portion of intestines had moved into his chest cavity due to a diaphragm defect.This abnormality severely compressed his right lung, causing severe breathlessness and chest pain that hindered his daily activities. To cure the boy, the main challenge was returning the large volume of organs—especially the liver—back into the abdominal cavity using laparoscopic instruments. The liver’s slippery surface made controlled handling difficult. Adding to the complexity, the liver had enlarged to nearly three times its normal size after remaining in the chest cavity for a prolonged period.Despite these difficulties, a team of surgeons completed the operation in about two hours using only three small incisions: one 10mm port and two 5mm ports. The surgeons carefully repositioned the liver, gallbladder, and intestines into the abdomen, expanded and checked the lung, and then repaired the diaphragmatic defect, reinforcing it with a surgical mesh.Doctors said the 11-year-old boy from Alwar was admitted to SMS Hospital with an extremely rare right-sided congenital diaphragmatic hernia. For two months, the child suffered worsening breathlessness and chest pain, especially while walking or running. The symptoms became so limiting that he stopped playing and his studies were affected. “Two weeks ago, he visited SMS Hospital’s OPD, where detailed investigations revealed a congenital defect in the diaphragm—the muscle separating the chest and abdominal cavities. Because of this defect, nearly 70% of his liver, along with the gallbladder and a large portion of the intestines, had migrated into the right side of his chest,” said Dr Jeevan Kankaria, senior professor (general surgery).He said due to the medical condition, the child was effectively functioning with only one lung.“Congenital diaphragmatic hernia is rare and is more commonly seen on the left side; right-sided cases are considered particularly uncommon and surgically challenging. Traditionally, such cases are managed through major open operations such as laparotomy, thoracotomy, or a large back incision. Instead, the SMS team opted for a laparoscopic approach, which is technically more demanding but less invasive,” he said.
