Surgery saves tiny Noah's tummy

Most young boys love stories about all things gory and gross, so little Noah Smallman is sure to be a hit in the playground when he tells his schoolmates the story of his birth.

Noah was born with gastroschisis, a condition where the bowel develops outside the abdomen as the foetus grows inside the womb.

The condition, which affects one in 5000 births, occurs when the muscles of the abdominal wall don't form correctly.

Paediatric surgeon Bruce Currie said: "The bowel is floating freely in the amniotic fluid and when the baby wees, their bowel gets baked in its own urine and it gets matted and thick and yuck."

The condition, which affects one in 5000 births, occurs when the muscles of the abdominal wall don't form correctly, allowing organs, such as the bowel, stomach or intestines, to protrude.

Without a covering of muscle and skin the bowel becomes irritated, inflamed and thick, and it cannot work properly.

Luckily for Noah's mother, Brooke Hammond, an 18-week ultrasound picked up the condition, so doctors at the Royal Hospital For Women were standing by to perform emergency surgery when Noah - followed by his bowel - was delivered at 37 weeks' gestation.

"We were shown photos of what it would look like, so we were prepared but when he came out it was still a shock - it was like frankfurters or bright-red hot dogs," Ms Hammond, 21, said.

The bowel was wrapped in cling wrap to stop it drying out, then Dr Currie whisked Noah to neonatal intensive care where a team of surgeons attempted to put it back inside his abdomen and close him up.

However, there was not enough room to fit the whole bowel in without squashing Noah's other organs, making it hard for him to breathe, so doctors placed a cover over the bowel and stitched it to his abdomen.


Called a "silo", the cover was gradually tightened over the next few days to slowly push the exposed bowel back into the abdominal cavity.

Once the silo was removed, the skin was closed up and all the tubes and ventilator were removed. Ms Hammond and her partner Matt Smallman, 22, finally got to hold their baby when he was seven-days old.

Noah, now three-weeks old, is still being fed through a tube and will remain in intensive care for at least another month, but Dr Currie says he should be home before Christmas.

Most babies with gastroschisis are born to mothers in their late teens or early 20s. While many are born premature, 80 per cent will be fine after initial surgery and, overall, more than 90 per cent of babies will survive.

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