THE clinical director of surgery at the trust which runs Basingstoke hospital today broke down while giving evidence at the inquest into the death of Elisha Langley.

Merv Rees, who examined 20-year-old Elisha before her death, was close to tears as he told the inquest how he and his colleague, Fenella Welsh, believed Elisha may have beeen suffering from abdominal problems, and said he was “astonished” when a CT scan revealed a brain abscess.

He said that “in hindsight and with speculation” that he believed the abscess must have been the result of a secondary infection, which built up under the skin, following an operation to remove a sebaceous cyst from her head.

He told the inquest that the wound had been closed so thoroughly after the operation “that the infection would be under tension” and the pus would have had to find “somewhere to go”- seeping through the skull and causing the abscess.

He added that there was no way of knowing what caused this secondary infection.

Coroner Keith Wiseman also heard from Mr Rees that the hospital, in Aldermaston Road, had taken extra measures to care for Elisha, of Worting Road, because of her learning difficulties, and had allowed the family to be with her from morning to night, ignoring usual visiting hours.

As previously reported in The Gazette, Elisha died on December 23, 2012. The operation to remove the cyst was carried out on November 19, 2012, and she had been readmitted to the hospital twice prior to her death, but the CT scan which ultimately diagnosed the abscess was not carried out until December 21.

Mr Rees said that the hospital has since made a number of changes to the way in which it deals with cases, including extra checks on any lumps of 5cm or more to “confirm that it does not need further reassurance from a CT scan”.

The inquest also heard from Dr Kandiah Chandrakumaram, who carried out the operation on Elisha.

Dr Chandrakumaram said he was satisfied after the operation that it had gone well, despite noticing during the procedure a roughness and erosion of areas on the skull- a symptom which is very rare.

He said: “The defects that we saw were of no significance at all” and he explained that this would have been caused by the cyst being in existence for a long period of time.

He said of the rough areas that he “did not think it was serious” after coroner Keith Wiseman put to him a quote from an independent report into the case that said: “one would not expect pressure atrophy (the wasting of tissue as a result of pressure) of the skull from the cyst”.

The report, read out by Mr Wiseman, continued: “If he had inferred this at the time it would have been cause for investigation and a scan.”

The inquest continues.