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07 Nov 2006
Life-saving op 

Thurein Tun's name means promising sun. But that is not why his parents and sisters hover around the youngest member of the family like the planets of a solar system. Their attention is born out of love and concern because this young man from Myanmar suffers from a condition for which now, at 25, he had to be operated on for the fourth time.

Thurein Tun was born with choledochal cyst, a condition where the bile duct is structurally abnormal, preventing the flow of bile. This resulted in inflammation and he suffered from jaundice.

"My father said it was when I was six or seven months old that I suffered bad colic. That was when the doctor found out I had the condition. Whenever it got painful, I would get a fever," he said through an interpreter. When he got older, he would sometimes miss school. Frail as he was, he could never join his friends for soccer. "While they played, all I could do was to spend my time alone in the classroom."

He is still frail, so his parents and siblings did not allow him to learn the family business - the timber trade.

Thurein Tun was 14 when he went for his first operation. "The cyst had grown, decreasing the bile flow. I was in great pain and suffered from jaundice. That was when my father decided I needed to have the condition corrected," he said.

It was 1995 and medical science was not advanced in Myanmar. The surgeon left the cyst with the abnormal diseased bile duct in place and sutured it to the small intestine to relieve the jaundice.

This procedure is no longer recommended as it is associated with a number of serious complications. Up to 70 per cent of the patients whose cyst is not removed have to be operated on again to remove the cyst.

That was exactly what happened to Thurein Tun. He had a second operation in 2001. His gut was badly infected but again the cyst was not removed. Then in 2003, he had to go for a third surgery as there was a massive build-up in his abdomen. As he was also bleeding excessively, the surgeon advised his family to fly him here for a last-ditch bid to correct his condition.

Associate Professor Pierce Chow, a senior consultant surgeon at the Singapore General Hospital (SGH), said: "Thurein Tun was bleeding profusely as he did in Myanmar so it was a challenge to find where the source of bleeding was. With the help of an endoscopy, the bleeding was found in the bile duct.

"After a series of specialised scans, we found that his cyst was still present and that he had developed a lot of dilated veins (varices) within the cyst. These were actively bleeding. His condition was grave and we had to carry out emergency surgery to stop the bleeding and save his life," Prof Chow said.

The six-hour operation was carried out on the night of July 24 and eight units of blood were needed. "As this was his fourth surgery in the area, it was difficult for surgeons. We removed his cyst, and ligated the varices to stop the bleeding. The one grace was his liver was still functioning properly," Prof Chow said.

Two weeks after his operation, a still weak Thurein Tun and his father returned to SGH for a follow-up check with the professor and to remove his stiches.

When told that he was well on his way to recovery, be beamed. He is looking forward to the Water Festival, Myanmar's traditional New Year Festival in April. "It will be first time I'd be able to participate in the Water Festival and I am looking forward to be part of it rather then watching from the sidelines," he said with a smile as bright as his name.

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