-
World Journal of Surgery 1993It has been widely acknowledged that exomphalos and gastroschisis are two different clinical entities. Their etiology and pathogenesis, however, remain controversial.... (Review)
Review
It has been widely acknowledged that exomphalos and gastroschisis are two different clinical entities. Their etiology and pathogenesis, however, remain controversial. Several techniques are available for making a prenatal diagnosis of these as well as many other malformations. Some prenatal treatment is possible, but operative management is the more usual course. In most cases, of omphalocele and gastroschisis, treated either conservatively or by any kind of surgery, intensive care is mandatory to support nutrition and often ventilation as well. Enteral nutrition at an early stage during the postoperative period might lead to bouts of necrotizing enterocolitis requiring aggressive medical treatment and sometimes even operative treatment.
Topics: Abdominal Muscles; Female; Hernia, Umbilical; Humans; Infant, Newborn; Intestines; Pregnancy
PubMed: 8337880
DOI: 10.1007/BF01658701 -
Seminars in Pediatric Surgery May 1996Infants with omphalocele and gastroschisis represent a challenging group of patients. Antenatal diagnosis may affect management by stimulating a search for associated... (Review)
Review
Infants with omphalocele and gastroschisis represent a challenging group of patients. Antenatal diagnosis may affect management by stimulating a search for associated anomalies, and by changing the site, mode, or timing of delivery. During the neonatal period, great care must be taken to minimize fluid and heat loss, and to prevent bowel distension. Although the goal of the surgeon is to accomplish abdominal wall closure in a single stage, a number of options exist where this is not possible. Other considerations include prevention and control of sepsis, nutritional support, respiratory status, and dysfunction of the liver, kidneys, and intestine because of increased abdominal pressure. Long-term outcome, in the absence of major chromosomal and structural anomalies, is excellent.
Topics: Abdominal Muscles; Female; Hernia, Umbilical; Humans; Infant, Newborn; Postoperative Complications; Pregnancy; Resuscitation; Ultrasonography, Prenatal
PubMed: 9138711
DOI: No ID Found -
Seminars in Pediatric Surgery Apr 2019After a diagnosis of omphalocele during pregnancy, questions regarding long-term prognosis are of primary importance for parents. It is imperative that their questions... (Review)
Review
After a diagnosis of omphalocele during pregnancy, questions regarding long-term prognosis are of primary importance for parents. It is imperative that their questions are answered with substantiated data to promote confident decisions for their children. They frequently express concerns regarding long-term survival, quality of life, need for more operations, feeding issues, motor and cognitive development, cosmesis, and the unique difficulties of giant omphaloceles. The available outcome studies that address these questions are discussed.
Topics: Abdominal Pain; Child; Child Development; Child Nutritional Physiological Phenomena; Child, Preschool; Chronic Pain; Gastroesophageal Reflux; Hernia, Umbilical; Herniorrhaphy; Humans; Infant; Infant, Newborn; Neurodevelopmental Disorders; Prognosis; Quality of Life; Treatment Outcome
PubMed: 31072460
DOI: 10.1053/j.sempedsurg.2019.04.004 -
European Journal of Obstetrics,... Jan 1999To determine an optimal route of delivery for fetuses with prenatally diagnosed omphalocele. (Review)
Review
OBJECTIVE
To determine an optimal route of delivery for fetuses with prenatally diagnosed omphalocele.
DATA SOURCE
MEDLINE search of years 1966-1996.
RESULTS
Descriptive retrospective analyses do not support the idea that cesarean delivery of fetuses with omphalocele is associated with an improved survival rate. However, most of those studies do not control for confounding variables like type and severity of associated anomalies, omphalocele size, prematurity rate, presence of trial of vaginal delivery, rate of intrapartum sac rupture, tertiary treatment centers accessibility, time and type of surgical correction, and postoperative morbidity. There is no evidence that vaginal delivery is safer than cesarean for fetuses with isolated small omphalocele. Fetuses with giant (>5 cm) omphalocele should be delivered by cesarean section. Vaginal delivery at term is offered for fetuses with coexisting life-threatening anomalies.
CONCLUSIONS
We propose that until randomized trial of vaginal and cesarean delivery for fetal omphalocele is available, the preferred mode of delivery would be the vaginal route as that is safer for the mother.
Topics: Abnormalities, Multiple; Cesarean Section; Female; Hernia, Umbilical; Humans; MEDLINE; Morbidity; Pregnancy; Pregnancy Outcome; Prenatal Diagnosis; Retrospective Studies; Trial of Labor
PubMed: 10192479
DOI: 10.1016/s0301-2115(98)00170-5 -
The Surgical Clinics of North America Apr 2006
Review
Topics: Gastroschisis; Hernia, Umbilical; Humans; Incidence; Infant, Newborn; Risk Factors; Treatment Outcome
PubMed: 16580922
DOI: 10.1016/j.suc.2005.12.003 -
The Surgical Clinics of North America Apr 1976From a historical curiosity at the turn of the century, today omphalocele and gastroschisis can be corrected with good results, thanks to innovative techniques and...
From a historical curiosity at the turn of the century, today omphalocele and gastroschisis can be corrected with good results, thanks to innovative techniques and better understanding of the newborn. Associated anomalies consist mainly of malrotation, Meckel's diverticulum, intestinal atresia, congenital heart defects, and genitourinary abnormalities. Nonoperative management in certain centers has been sucessful for the very large omphaloceles with an intact sac; however, a secondary procedure is necessary. In the past 10 years, the use of Silastic sheeting and total parenteral nutrition has allowed early repair of even the most severe cases, with excellent end results and low mortality.
Topics: Digestive System Abnormalities; Hernia, Umbilical; Humans; Infant, Newborn; Silicone Elastomers
PubMed: 1265601
DOI: 10.1016/s0039-6109(16)40882-0 -
AORN Journal Mar 1970
Topics: Hernia, Umbilical; Postoperative Care
PubMed: 5198784
DOI: 10.1016/s0001-2092(07)67217-2 -
Journal of the National Medical... Feb 2021Omphalocele is characterized as a ventral wall defect in which there exists a midline herniation of abdominal viscera into the base of the umbilical cord. Fetuses with a...
Omphalocele is characterized as a ventral wall defect in which there exists a midline herniation of abdominal viscera into the base of the umbilical cord. Fetuses with a diagnosis of this entity are at a significantly increased risk of having an aneuploidy, additional anomalies, or associations with other syndromes such as Beckwith Wiederman. Secondary to these interconnections, there is an elevated risk of fetal loss in affected pregnancies. Detection of concordant abnormalities, appropriate genetic counseling, and involvement of pediatric subspecialties are paramount in affording a prognosis, and providing optimal perinatal management of omphalocele.
Topics: Child; Female; Hernia, Umbilical; Humans; Pregnancy; Prognosis; Ultrasonography, Prenatal
PubMed: 32747314
DOI: 10.1016/j.jnma.2020.07.006 -
West African Journal of Medicine Aug 2022Omphalocele consists of congenital malformation of anterior abdominal wall defects occurring at the midline with herniation of the viscera through this defect. Giant... (Review)
Review
BACKGROUND
Omphalocele consists of congenital malformation of anterior abdominal wall defects occurring at the midline with herniation of the viscera through this defect. Giant omphaloceles constitute a challenging situation as such conservative management has been advocated as an effective method of treatment. This study aimed to compare the conventional method of dressing the omphalocele sac using gauze, an escharotic agent, and a crepe bandage to our improvised method of the usage of a sterilization wrap over the escharotic agent with a crepe bandage.
METHODS
This was a retrospective comparative review of 7 babies with giant omphalocele that was treated with topical honey and the non-adherent sterilization wrap covering (group B) and compared with 6 babies that had honey, sofratulle ,and dry gauze covering (group A) that was initially done in our center.
RESULTS
All of the babies who were in group B had an uneventful epithelization of the sac with no rupture; also, no death occurred in this group. However, three in group A had sacs that ruptured before epithelization. Two of these died from complications of sepsis following rupture of the sac, one had a small point on the sac which was ruptured and it healed with a dressing left in place for a week.
CONCLUSION
The use of Kimberley-Clark sterilization wrap prevents rupture of the sac while using the escharotic agent, thereby reducing mortality. We advocate that gauze should not make any contact with the omphalocele sac.
Topics: Conservative Treatment; Hernia, Umbilical; Humans; Infant; Retrospective Studies
PubMed: 36057973
DOI: No ID Found -
Einstein (Sao Paulo, Brazil) 2022To relate omphalocele and biliary atresia and investigate possible embryological correlations that justify the simultaneous occurrence. A female preterm newborn...
To relate omphalocele and biliary atresia and investigate possible embryological correlations that justify the simultaneous occurrence. A female preterm newborn diagnosed as omphalocele; cesarean delivery, weight 2,500g, 46 XX karyotype. Initially, the newborn remained fasting and on parenteral nutrition, and enteral diet was introduced later, with good acceptance. On the 12th day of life, the newborn presented direct hyperbilirubinemia, increased levels of liver enzymes and fecal acholia, with a presumptive diagnosis of biliary atresia. However, the ultrasound was inconclusive, due to anatomical changes resulting from omphalocele. A surgical approach was chosen on the 37th day of life aiming to confirm diagnosis of biliary atresia and to repair omphalocele. During the surgical procedure, structural alterations compatible with biliary atresia were observed, later confirmed by pathological examination; a hepatoportoenterostomy was performed and the omphalocele was corrected. She evolved well in the postoperative period, with a decrease in direct bilirubin and liver enzymes, as well as resolution of fecal acholia, and was discharged in good clinical condition. This is a bizarre and extremely rare association, but the prognosis may be good when an early diagnosis is made and surgery performed, besides support and clinical management to prevent complications in the perioperative period. Although the pathogenesis of the diseases has not been fully defined yet, there is, to date, no direct relation between them. The association between omphalocele and biliary atresia is extremely uncommon, with only two published cases.
Topics: Biliary Atresia; Bilirubin; Cholestasis; Female; Hernia, Umbilical; Humans; Infant; Infant, Newborn; Parenteral Nutrition; Pregnancy
PubMed: 36169552
DOI: 10.31744/einstein_journal/2022RC0072