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The 5 day old newborn of Shivalini (Mother) was admitted in Paras Hospitals, Gurgaon with the complaint of non – bilious vomiting after every feeds and passing stools in small amounts since birth. Initially, baby was taken to the nearest nursing home for the treatment. After that with no improvement in the condition, the baby had been taken to other three hospitals before he arrived in Paras Hospitals.

Multiple referrals and frequent vomiting had led to the severe dehydration, aspiration and development of septicemia in the newborn. X-ray abdomen showed a double bubble appearance with absence of distal gases. The double bubble sign is seen in infants and represents dilatation of the proximal duodenum and stomach. In such cases, distinguishing the diagnoses depends on clinical presentation, says, Dr. Monika Nanda, Senior Consultant, Pediatric Surgery, Paras Hospitals, Gurgaon.

The diagnosis of partial duodenal obstruction was made and the baby was taken up for surgery after initial stabilization and the findings of duodenal web were confirmed.

Thus, timely referral to a neonatal surgeon helped in accurate diagnosis and early management of these correctable abnormalities, and thereby reducing undue morbidity and mortality of neonates.

Neonatal surgery is a highly specialized branch of Pediatric Surgery. Diagnosis of any congenital abnormality at birth or in the antenatal period has a tremendous psychological impact on the parents but proper counseling and regular follow up with neonatologist and neonatal surgeon can help to decrease the fear and aid in proper and timely management of these abnormalities.

Some of the congenital abnormalities treated by Pediatric surgeon are –

• Tracheo- Oesophageal Fistula
• Anorectal malformations (absence of normal anal opening in a newborn
• Intestinal Atresias and Malrotation
• Hirschsprung’sDisease (present in newborns not passing stools in the first 24 hours)
• Abdominal Cysts
• Posterior Urethral Valves(When newborn do not pass urine in stream)
• Abdominal wall defects like Exstrophy Bladder, Omphalocele