Case Study: A Rare Battle Won – Apple Peel Atresia Baby Saved at Inamdar Hospital Pune
Pune, 22nd September 2025: What began as a moment of joy quickly turned into heartbreak for the Bonawate family. On August 3, 2025, Pramila Bonawate delivered a late preterm baby girl through an emergency Caesarean section for fetal distress at Inamdar Multispecialty Hospital, under the care of senior obstetrician and gynecologist Dr. Priyanka Gupta.
Within hours, however, the newborn began vomiting green bile after feeds. Her sugar levels dropped, and her blood pressure plummeted. She was immediately shifted to the Neonatal Intensive Care Unit (NICU) under the supervision of Dr. Ashwin Borade, Senior Paediatrician and Neonatologist.
A Rare Diagnosis
Despite intensive care, the baby’s condition worsened with persistent bilious vomiting. X-rays and sonography revealed dilated intestinal loops, pointing to a small bowel obstruction. A pediatric surgical consultation with Dr. Pranav Jadhav, senior neonatal and paediatric surgeon, led to an exploratory laparotomy.
To the team’s astonishment, the baby was diagnosed with a rare congenital anomaly—jejuno-ileal atresias with multiple intestinal atresia and apple peel deformity.
“Apple peel deformity with multiple intestinal atresias is extremely rare. The intestine coils around its blood vessel in a spiral pattern, much like peeling an apple. If untreated, it is life-threatening and carries a poor prognosis,” explained Dr. Jadhav.
Dr. Jadhav, along with Dr. Dhananjay Vaze, performed multiple resections and anastomoses to remove diseased portions and reconnect the intestines.
The Challenges Post-Surgery
The road to recovery was far from easy. Due to the extensive surgery, the baby was unable to accept feeds for nearly 14 days. Soon after, she developed life-threatening sepsis, requiring intensive treatment with IV antibiotics, antifungals, and continuous monitoring.
“Every hour was a fight for survival. Managing nutrition and preventing infection were our biggest challenges,” recalled Dr. Borade.
Once signs of recovery appeared, slow feeding was cautiously reintroduced. However, stress and separation affected Pramila’s milk production. Dr. Rani Balgude, Lactation Consultant, stepped in to counsel the mother and arranged pasteurised donor human milk, which proved vital for intestinal healing.
“Breast milk or donor milk is not just food—it is medicine for fragile babies recovering from intestinal surgery,” emphasized Dr. Balgude.
Teamwork and Compassion
After 35 days in the NICU, the baby was finally discharged, thriving on full feeds. “This case is a shining example of teamwork—surgeons, neonatologists, NICU nurses, and lactation experts—all played a role in saving this life,” Dr. Borade noted.
For Pramila, the journey was both devastating and miraculous. With tears in her eyes, she said:
“I had almost lost hope. Every night I prayed for just one more day with my baby. Today, seeing her healthy in my arms, I feel I have been given a second life.”
A Community Effort
The prolonged NICU stay and complex surgery costs were overwhelming for the family. The Chief Minister’s Office (CMO), with support from Inamdar Hospital’s PRO team, extended crucial financial assistance, easing the family’s burden.
Understanding Apple Peel Atresia
Apple Peel Atresia is a rare congenital intestinal defect caused by disruption in the blood supply during pregnancy. The intestine ends in a blind pouch and coils in a spiral fashion, leading to severe obstruction. Premature babies are especially vulnerable. Surgical correction is the only treatment, but recovery demands meticulous neonatal care.
A Story of Hope
This case goes beyond medical statistics—it is a story of resilience. With expert care, state support, and a mother’s courage, a fragile life not only survived but triumphed against the odds.
As Dr. Borade summarized:
“Healing a baby means healing an entire family. And when science, compassion, and community come together, even the rarest battles can be won.”
