A study of 40 cases of omphalocele

Abstract EN

Background : Congenital abdominal wall defects(probably omphalocele) were described as early as the first century.

Successful repair of omphalocele was first reported in 1803.[1] Excising sac and covering the viscera with skin flaps was described in 1948[2].

In 1967, the staged repair of omphalocele with artificial material sewn to the facial edges was introduced [3].

Objectives : To evaluate the prenatal diagnosis, post delivery management including surgical correction and prognosis, in Iraq.

Setting : All of our patients were managed in pediatric surgery center at children welfare teaching hospital in Baghdad between may 2004 to may 2007.

Patients and methods : The medical records of our patients were recorded for prenatal diagnosis, birth order, sex, weight, type of delivery, maternal age, gestational age, size of the defect, associated anomalies, treatment and out come.

All patients had been examined to exclude associated congenital anomalies.

All patients investigated for blood group, blood glucose and urea, echo-cardiography and ultra sound of abdomen done for them.

Vitamin K were given to all patients as 1 mg / kg in single dose.

Results : forty full term patients, twenty male and twenty female.

Diagnosis of all of patients were done clinically by inspection, while ten of the patients were diagnosed prenataly by ultrasound examination (25 %).

six of our patients (15 %) had C \ S delivery while the rest were product of normal vaginal delivery.

Only two patients (5 %) had rupture of the sac at presentation.

thirty patients (83.4 %) treated successfully by primary closure, six patients (16.6 %) treated by staged closure.

four patients (10 %) died preoperatively secondary to sepsis because of low birth weight and associated anomalies, two patients (5 %) died postoperatively for the same reasons.

Conclusion : All our patients were full term infants.

No difference in male to female ratio.

Omphalocele minor not interfere with birth weight.

C \ S have no additional benefit over normal vaginal delivery.

Mortality is high in patients have major associated anomalies or big defect.

The treatment is surgical include removal of the sac and primary closure or staged closure.

The post operative period was smooth for 90 % of the patients.