Four-Week Old Infant Undergoes Minimally Invasive Gallstone Removal

April 16, 2019

Imagine hearing the words, “Your baby has gallstones.” For Chicagoans, Michael and Kara Baldev, their journey as first-time parents has been anything but ordinary.

On November 13, 2018, Kara gave birth to a healthy baby boy, Atlas. But when he was 3-weeks old, the new parents noticed Atlas’ stool was white and chalky. Concerned, they made an appointment with his pediatrician where blood tests and an abdominal ultrasound were performed. The ultrasound revealed a blockage in Atlas’ bile ducts, and he was immediately sent to Lurie Children’s and admitted.

“When we found out Atlas had a blockage in his bile duct, we were horrified,” said Michael, Atlas’ dad. “We were in the neonatal intensive care unit and the medical team was considering reasons like biliary atresia. We feared he might need a liver transplant.”

Additional tests discovered that Atlas’ blockage was due to a gallstone that was 5 millimeters, half the size of a penny – which is extremely rare in babies.

“Doctor’s waited several days to see if he would pass the gallstone naturally but when he didn’t they talked of surgery,” said Michael. “As parents we were relieved that it wasn’t life-threatening but were worried about the next steps.”

Minimally Invasive Procedure for the Tiniest Patients

Because of Atlas’ size – 9 pounds – his medical team was reluctant to perform surgery and consulted with pediatric interventional radiologist Shankar Rajeswaran, MD. Interventional radiology uses image guidance to help perform minimally invasive procedures that once required open surgery. The images provide road maps that help the interventional radiologist guide instruments through the body.

“To remove the gallstone, I made an incision the size of a pinprick and then inserted a small balloon that measured 4 millimeters into his bile duct,” said Dr. Rajeswaran, one of a handful of pediatric interventional radiologists in the country. “Then we were able to maneuver the balloon through his bile duct to push the stone into his bowel, so he would pass it naturally.”

Three hours later, the procedure was completed and with the incision being so tiny there were no stitches. Atlas was discharged seven days later on Christmas Eve, just in time for his first Christmas.

“Atlas is a happy kid, hitting all the milestones that he should, responding to faces, our voices and following things with his eyes,” said Michael. “We are so grateful to Lurie Children’s and the care Atlas received.”