How Did a Tripura Surgeon Fix a Newborn’s Twisted Intestines?

Agartala: The human body is supposed to develop in a very specific way before birth. Sometimes, though, nature gets it wrong. That’s what happened to baby Sutradhar – his intestines grew in completely the wrong places, creating a medical emergency that could only be fixed by cutting him open and putting everything back where it belonged.

Nobody expects their newborn to start throwing up bile. But that’s exactly what happened to a couple Debashree Sutradhar (28) and Ripon Sutradhar just days after welcoming their second child on May 10, 2025, at Indira Gandhi Memorial (IGM) Hospital.

Their son had been delivered by cesarean section without any complications. Everything seemed normal at first. But by day five, something was clearly very wrong. The baby couldn’t keep anything down and was constantly vomiting a green, bitter liquid – bile that should never come out of any baby’s stomach.

When local doctors hit a wall

The worried parents rushed their five-day-old son to IGM Hospital’s ICU. The pediatric specialist there took one look at the symptoms and knew this was beyond what their facility could handle. That green vomit – what doctors call “bilious vomiting” – is one of the most alarming signs a doctor can see in a newborn. It’s a red flag that screams intestinal obstruction and demands immediate action.

This wasn’t your typical newborn feeding problem or reflux issue. This was something serious – something that needed a surgeon who specialized in operating on babies.

The doctor made a crucial call: send the baby to the superspecialist pediatric and neonatal surgeon Dr. Aniruddha Basak at Tripura Medical College (TMC) at Hapania in Agartala, West Tripura. If anyone could figure out what was wrong and fix it, it would be him.

Dr. Basak is brutally honest about the challenges he faces. “Delay in referral and limited resources in TMC – these are the main challenges,” he says. It’s not the kind of polished answer you’d expect from a doctor, but it’s the truth. In places like Tripura, pediatric surgeons don’t have all the fancy equipment that big city hospitals boast about. They make do with what they have.

The shocking discovery: when intestines grow backward

When the seven-day-old baby arrived under Dr. Basak’s supervision, the surgeon quickly realized they were dealing with something most doctors will never see in their entire careers. The baby’s intestines were completely reversed – right side organs on the left, left side organs on the right. It was like looking at a mirror image of how human anatomy is supposed to work.

“It’s due to failure in rotation of the gut during embryogenesis,” Dr. Basak explains. But put simply, something went wrong during a critical period of the baby’s development in the womb.

Here’s what should have happened: Between the fourth and eighth weeks of pregnancy, every baby’s intestines go through an incredibly complex dance. They rotate counterclockwise around a major blood vessel called the superior mesenteric artery, temporarily poking out of the tiny abdomen before spinning back in and settling into their proper positions. It’s like an intricate choreography that happens automatically in almost every pregnancy.

But for baby Sutradhar, this dance was interrupted. The intestines never completed their rotation, leaving them in completely wrong positions. The medical name for this is intestinal malrotation, and it’s about as serious as it sounds.

Dr. Basak says this happens to “1 in 500 live births” – though some medical studies suggest it might be closer to 1 in 6,000 when you’re talking about cases that actually cause symptoms. The discrepancy exists because many people live their entire lives with malrotated intestines and never know it. But when symptoms do appear, especially in newborns, it’s usually a medical emergency.

The deadly twist: why this condition kills

The malrotation itself might not kill you, but what it leads to absolutely can. The biggest danger is something called volvulus – when the already misplaced intestines twist around themselves like a rope. When this happens, it cuts off blood supply to the bowel, just like a tourniquet cuts off circulation to a limb.

Without blood flow, intestinal tissue starts dying within hours. The medical term is “necrosis,” but the reality is simpler and more terrifying: parts of the baby’s digestive system were literally dying from lack of oxygen and nutrients.

The continuous bile vomiting that brought baby Sutradhar to the hospital was his body’s way of screaming that something was blocked. The twisted intestines were preventing normal digestion, and every hour that passed made things more dangerous.

There’s also another complication that can happen with malrotation: abnormal bands of tissue called Ladd’s bands can form and compress parts of the intestine, creating blockages even without the deadly twisting. These bands often stretch from the displaced large intestine over the small intestine, squeezing it like a clamp.

If left untreated, the cascade of complications is swift and often fatal: bowel perforation (holes in the intestinal wall), peritonitis (dangerous infection of the abdominal lining), sepsis (life-threatening body-wide infection), and shock. For a five-day-old baby, this progression can happen in a matter of hours.

Surgery with whatever’s available

Dr. Basak faced a dilemma that many surgeons in resource-limited settings know all too well. He had to perform one of pediatric surgery’s most complex procedures – something called a Ladd’s Procedure – but he didn’t have specialized pediatric equipment.

“I performed a critical operation on a seven-day-old baby using the general equipment and resources available in TMC that are also used in general surgical procedures in adults too,” he says matter-of-factly.

Think about that for a moment. This surgeon had to operate on a week-old baby using tools designed for grown-ups. It’s like trying to repair a watch with hammers and screwdrivers instead of precision instruments. But sometimes, skill matters more than equipment.

Dr. Basak has done this before. In a previous case involving a rare condition called Gastroschisis, he actually improvised by creating a specialized medical bag from a simple urine collection bag because the proper equipment “wasn’t readily available at TMC.” His track record shows a pattern of making miracles happen with whatever’s at hand.

The Ladd’s procedure: rebuilding a baby from the inside

The Ladd’s Procedure isn’t something you can learn from a textbook. Named after Dr. William Ladd who pioneered it, this surgery is like completely renovating the inside of a house while the family is still living in it.

On May 15th, when the baby was just seven days old, Dr. Basak and his team spent two grueling hours in the operating theatre. Two hours to undo what went wrong during nine months of development. Two hours that would determine whether this child would live or die.

The surgery was a complete success. Research shows the Ladd’s Procedure has success rates above 90%, and in this case, the outcome was definitively positive.

Life or death decision

Dr. Basak doesn’t sugarcoat the stakes. “This disease is extremely rare and without immediate surgery, it would have been impossible to save the baby’s life.”

There’s no medicine for intestinal malrotation. No therapy, no wait-and-see approach, no gradual treatment. “No alternative way,” Dr. Basak states bluntly when asked about other treatment options. It’s surgery or death – that simple and that brutal.

The surgeon knew that every minute he delayed, the baby’s chances got worse. Operating on a seven-day-old infant brings its own set of challenges – immature liver and kidney function, difficulty with anesthesia management, precise fluid balancing, and the need for sophisticated post-operative care. The extreme youth of the patient escalated the complexity and risks exponentially.

But the surgery worked. Almost immediately after the procedure, the constant bile vomiting stopped. The baby’s body could finally process food normally. Within days, it was clear the child would make a full recovery.

“Through the surgery, I restored all the baby’s intestines to their normal position, giving the child a new lease on life,” Dr. Basak says. It’s not just medical jargon – it’s literally true. Without this surgery, the baby would have died within days, possibly hours.

The bigger picture: healthcare heroism in challenging times

Dr. Basak’s success becomes even more remarkable when you understand the broader context. His previous cases read like a catalog of medical miracles: successfully treating Gastroschisis by improvising specialized equipment, removing a sacrococcygeal teratoma from a 17-day-old infant, and now this intestinal malrotation case.

Each success story highlights the same theme: exceptional surgical skill overcoming significant resource limitations. “The success rate for Gastroschisis surgeries is relatively low, primarily due to delays in referring such cases to tertiary care centers,” Dr. Basak has noted from his previous experience. He’s seen how “improper transportation of newborns often leads to complications like hypothermia and sepsis,” which severely diminish survival chances.

The pattern is clear: delays kill babies. For conditions like intestinal malrotation, where bilious vomiting demands immediate attention, any delay in reaching a specialized center can lead to irreversible bowel damage and death.

A message to fellow doctors

The success of this surgery has given Dr. Basak a platform to address something that’s been bothering him – the need for better referral systems in the region.

“Please refer any neonatal or pediatric surgical case to me at Tripura Medical College as soon as possible, because early diagnosis and early definitive treatment is the key to better prognosis,” he urges his fellow doctors.

It’s both a plea and a promise. A plea for other doctors to recognize when they’re in over their heads and refer quickly. A promise that he’ll be there to handle cases that others can’t.

The message hits home because delays kill babies. Through his advocacy, Dr. Basak is essentially functioning as both surgeon and public health champion, using his authority and experience to address critical gaps in regional healthcare.

This isn’t just professional rivalry or ego – it’s a surgeon who has seen too many preventable deaths fighting to create better systems. His passionate call for early referral transcends clinical care; he’s actively working to change practices across the region.

What this means for the future

The most remarkable thing about this whole story might be what Dr. Basak says about the baby’s future: “Nope, it’s done and dusted, this intestinal malrotation problem is permanently solved.”

That seven-day-old baby who nearly died will grow up completely normal. He’ll never have to worry about this condition again. He’ll play sports, eat whatever he wants, live a totally ordinary life. The surgery didn’t just save his life – it gave him a normal life.

For his parents, Debashree and Ripon, the gratitude is overwhelming. They brought their son to the hospital expecting the worst and went home with a completely healthy baby. Both parents made sure to thank Dr. Basak and his team, knowing that without them, they’d be planning a funeral instead of a homecoming.

The child is healthy now, discharged from the hospital within days of the surgery just as predicted. The continuous vomiting has stopped, his digestive system is working normally, and his parents can finally breathe easy.

Beyond one baby’s story

This case represents something bigger than just one successful surgery. It demonstrates that Tripura Medical College is increasingly establishing itself as a crucial tertiary care center for complex pediatric cases in the region. Through Dr. Basak’s leadership and expertise, TMC is proving that complex neonatal surgeries can be successfully performed in regional medical centers, even when resource limitations exist.

For the medical community at Tripura Medical College, this surgery was a source of pride and celebration. It proved that they could handle some of the most complex cases in pediatric medicine, even with limited resources. Without such specialized units and dedicated surgeons willing to innovate, many newborns with congenital anomalies in the region would face grim prognoses.

The success also highlights how medical excellence can transcend resource limitations through knowledge, skill, and adaptability. Dr. Basak’s ability to perform this complex procedure using standard surgical equipment demonstrates that the most crucial resource in specialized medicine is often the surgeon’s expertise and experience rather than specialized equipment alone.

But the real impact of Dr. Basak’s work extends far beyond this one family. Every successful case like this builds confidence in local medical capabilities and shows other doctors what’s possible when you combine skill with determination. It provides a beacon of hope where specialized care might otherwise be inaccessible.

The baby who was born with his insides upside-down is now just another healthy newborn, ready to live a completely normal life. And somewhere in Tripura, Dr. Basak is probably getting ready for the next impossible case that everyone else will send his way, armed with whatever basic tools are available and the knowledge that sometimes, that’s all you need to save a life.