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Doctors save 4-year-old girl pierced by iron rod through the jaw

Doctors save 4-year-old girl pierced by iron rod through the jaw


Sagaya Fernando

Mumbai: 7 August 2020


Like all children of her age, 4-year-old Jagyanseni Gouda of Khandadeuli village in Odisha state of India was playing on the under-construction terrace of her maternal uncle’s house on August 2 at around 8 am.


Accidentally she slipped and had a free fall over iron rods used for staircase concreting. And one of the rods pierced through her jaw.


Her parents and neighbours cut the jutting rod with a manual cutting blade which took about an hour before rushing her to a nearby primary health care centre. There they were referred to the state-run Maharaja Krishna Chandra Gajapati (MKCG) Medical College & Hospital at Brahmapur, 44 kms away.


“The child was brought to our hospital on August 3, 24 hours after the accident. The rod had pierced through the floor of mouth and going through 2/3rd of the tongue anterior. She was given primary resuscitation and stabilised by resident surgeon Dr V Rajesh. After resuscitation, Otorhinolaryngology consultant on duty was called for. On attending the call Dr Mamta Sahoo took second reference from paediatric surgery department, and we took a look into the baby clinically,” informed Dr Manas Ranjan Dash, paediatric surgeon at MKCG Hospital.


As per Dr Dash, the child had around 40 cm long cast iron rod which was ribbed and traversed digastric triangle in floor of mouth. 


“The entry wound over skin was not healthy with clots attached over surrounding foreign body,” said Dr Dash.


Dr. Pranaya Panigrahi assisting him asked for a quick routine blood investigation and Rapid antigen testing for Covid 19 so as to prepare the case for surgery.


“After getting preanesthetic fitness from Dr Ludham, the patient was shifted to OT. Preoperatively Dr Mallick and team of surgeons decided to have a tracheostomy secured for airway management and to proceed. Practically that was not possible as baby's odd posture restricting movement of neck. Default position of baby neck was toward right about 90 degree from anterior midlin plane,” said Dr Dash, adding that after sedating the patient, the rod was pulled with a backup plan of laryngoscopy and intubation in case of catastrophic bleeding from wound site


“To our luck we had not encountered any bleed which made the baby breathing spontaneously and she was observed in the OT for any airway obstruction requiring tracheostomy,” said Dr Dash.


The child’s condition has improved a lot and she is now recovering in intensive care unit. On August 6 she started taking food orally, and will be discharged soon, added Dr Dash. 


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