Balloon inside me

It was in 2003 when Mr Jansen Monim discovered that he had what he thought was a swollen spleen in a regular check-up in Indonesia.

“I was told I needed an operation, but I was not sure that there was something really wrong. The only thing I felt was that my back ached when I was tired,” said the athletic sportsman, who was a keen volleyball player in his younger days.

Mr Monim, who is now the Chief of Public Works in Papua in Indonesia, then went for a scan in 2006.

At the time, he could feel that there was a lump growing in his abdomen.

“It was heavy, like a balloon filled with water inside me, swishing around,” he said.

At the time, the CT scan showed that it was a tumour measuring 15cm by 15cm by 20cm. The doctors wanted to operate but again, Mr Monim didn’t want to. The next year, he again went for a check-up, this time in Kuala Lumpur. The tumour had grown. Then in 2008, he came to Singapore and the tumour was already 16cm by 16.5cm by 22cm.

By that time, it was becoming a burden, and he decided to get rid of it.

The man who would do the operation was Dr Teoh Tiong Ann, a Consultant Colorectal & General Surgeon.

He said: “When I first saw the patient and the scans, I was very concerned if I could actually remove the whole mass. I was also very concerned if the mass was adherent (stuck) to any of the surrounding structures.

The kidney, the vessels to the kidney, the colon, the stomach and spleen were all next to it. With this large size and the length of time it has been present, any of the adjoining structures may be involved. I was also unsure of the malignant potential of the mass. I felt that this was a great challenge.”

But why did the patient wait so long?

“It’s sometimes difficult to wonder what people think. Even as doctors, we ourselves have denial or are just too busy or caught up with other things in our lives to get something addressed medically for our own medical problems. Of course things would have been different if there was pain and other bothersome symptoms,” said Dr Teoh.

He said that while planning for surgery, he had to consider the different scenarios.

“I was most concerned about getting the entire mass out completely and also what other organs I had to remove with it. In the to Mr Monim that I could not tell him exactly what else I needed to remove in addition to the mass but I had to decide only during the surgery. I told him that I might have to even remove the kidney or part of the pancreas or stomach or intestine.

I was most afraid of severe bleeding occurring during the surgery which would be very dangerous.”

While doing the surgery, he and his colleague, Dr Chew Soo Ping, took each step very carefully. There were many blood vessels that they had to go through, to free up the tumour.

But, as they progressed, they slowly pried the tumour free from the surrounding organs.

“We were elated when we finally could remove the entire tumour as a whole without sacrificing any other organs and without too much bleeding. When we finally removed the tumour from the body, it was almost like delivering a baby weighing 3kg!” recalled Dr Teoh.

We were so very happy and relieved that it was performed successfully without any complications. Mr Monim also made excellent recovery.”

A few days after the surgery, Mr Monim was well enough to walk around, and even wandered to Lucky Plaza to get new trousers tailored. “I’ve lost some weight, as you know,” he joked.

He said that he was “surprised, amazed and a little frightened” when he saw what a huge tumour had come out of his body. The father of three children, aged 12, 24 and 27 said he was delighted with the outcome, and to know that the tumour was not cancerous.

“I am pleased with the outcome, and want to thank my doctors, my nurses. Coming here is not like staying in a hospital, it is like a hotel. Not cheap, but then, good health is expensive. Expensive, but worth paying for,” he said.

Dr Teoh Tiong Ann
Consultant Colorectal & General Surgeon
MBBS, FRCS (Edin), FAMS (General Surgery), MMed (Surgery)

Teoh Colon, Rectum & General Surgery 3 Mount Elizabeth #05-04
Mount Elizabeth Medical Centre
Singapore 228510
Tel: (65) 6738 9133
Fax: (65) 6738 7889
Email: teohsurg@singnet.com.sg