[China Tech] Shanghai Doctors Successfully Treat Critically Ill 34-day-old Infant

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A 34-day-old infant, weighing just 4 kilograms and suffering from severe malnutrition and a life-threatening congenital gastrointestinal problem, has been successfully treated in Shanghai.

The multidisciplinary team was led by Dr Zhou Pinghong of Zhongshan Hospital's Endoscopy Center.

The boy, nicknamed Xiaoxi, began regurgitating milk 20 days after birth, with symptoms rapidly worsening by day 27, including violent and repeated vomiting. By 31 days old, he was vomiting up to eight times a day, causing his weight to plummet to a critical 4 kilograms.

Xiaoxi was diagnosed with congenital hypertrophic pyloric stenosis – a common neonatal gastrointestinal malformation characterized by abnormally thickened pyloric muscles that narrow the digestive tract and block food passage. He did not respond to medication.

His family sought help from Dr Zhou, a leading expert in minimally invasive digestive surgery.

The case posed extraordinary challenges, comparable to "carving patterns on rice paper." The young, low-weight infant faced high anesthetic risks, with an extremely thin and fragile gastric wall and a surgical space smaller than a fingertip, creating a high risk of perforation or massive bleeding.

Zhou immediately assembled a multidisciplinary team, including anesthesiology, ultrasound, intensive care, general surgery, and pediatrics, to formulate a precise surgical and emergency plan.

On April 14, the team performed a Gastric Per-Oral Endoscopic Myotomy (G-POEM), a state-of-the-art, minimally invasive procedure. Under direct gastroscopic visualization, the surgeons created a submucosal tunnel 3 centimeters from the pylorus to access the lesion safely without damaging the outer gastric wall.

With extreme precision, Zhou precisely incised and completely transected the 1-centimeter-thick hypertrophic pyloric sphincter. The 30-minute procedure caused no bleeding, with the pyloric opening significantly enlarged post-operation.

G-POEM is safer, less painful, and faster to recover from than traditional open surgery for young and light individuals. It uses natural orifice access to accurately relieve obstruction.

Following the procedure, Xiaoxi was monitored in the hospital's intensive care unit overnight before being transferred to the pediatric ward in stable condition. He showed steady improvement: no fever post-surgery, tolerated sugar water on day three, resumed full oral feeding with no vomiting on day four, and had normal bowel movements.

Xiaoxi was discharged in good health on April 21, with his family expressing deep gratitude to the medical team for saving their baby.