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Giant omphalocele

Brent Bauman, Daniel Stephens, Hannah Gershone, Connie Bongiorno, Erin Osterholm, Robert Acton, Donavon Hess, Daniel Saltzman, Bradley Segura
PURPOSE: Despite the numerous methods of closure for giant omphaloceles, uncertainty persists regarding the most effective option. Our purpose was to review the literature to clarify the current methods being used and to determine superiority of either staged surgical procedures or nonoperative delayed closure in order to recommend a standard of care for the management of the giant omphalocele. METHODS: Our initial database search resulted in 378 articles. After de-duplification and review, we requested 32 articles relevant to our topic that partially met our inclusion criteria...
October 2016: Journal of Pediatric Surgery
A Binet, E Supply, S De Napoli Cocci, M De Cornulier, H Lardy, A Le Touze
OBJECTIVE: According to major difficulty for the giant omphalocele management in the visceral reintegration and the parietal closure, many teams use currently conservative treatment by topical application. These techniques are suppliers of a covered eventration and a scar sequela requiring a complementary treatment. We report the place of the tissue expansion as complementary treatment. PATIENTS AND METHODS: Two patients with a giant omphalocele benefited from a protocol of cutaneous expansion for the correction of their abdominal scar±of their residual eventration...
August 25, 2016: Annales de Chirurgie Plastique et Esthétique
Sonali Malhotra, Shilpa Kumta, Alok Bhutada, Elka Jacobson-Dickman, Roja Motaghedi
INTRODUCTION: Neonatal thyrotoxicosis is a life-threatening condition with potentially irreversible neurologic sequelae. Most cases are seen in neonates born to mothers with Graves' disease. Topical iodine-induced hypothyroidism has been reported in neonates, but iodine-induced neonatal hyperthyroidism has not been described; albeit a familiar entity in adults. CASE DESCRIPTION: Herein we present a unique case of a neonate, born with a giant omphalocele, who was treated with topical povidone-iodine dressings to promote escharification, in preparation for delayed surgical closure...
April 2016: American Journal of Perinatology Reports
Y J Blumenfeld, K E Milan, E Rubesova, K G Sylvester, A S Davis, V Y Chock, S R Hintz
No abstract text is available yet for this article.
September 2016: Ultrasound in Obstetrics & Gynecology
Daisy Vieira Travassos, Albertien M van Eerde, William L M Kramer
The management of giant omphaloceles at our department is primarily conservative. However, management can be challenging if the omphalocele is ruptured or the sac has to be removed. We report a case in which a giant omphalocele in a newborn female patient was managed by covering the abdominal defect with non-cross-linked intact porcine-derived acellular dermal matrix (Strattice reconstructive tissue matrix, LifeCell Corp., Branchburg, New Jersey, United States) sutured to the fascia combined with vacuum therapy...
December 2015: European Journal of Pediatric Surgery Reports
Beau Aldridge, Alan P Ladd, Jacqueline Kepple, Teresa Wingle, Christopher Ring, Evan R Kokoska
BACKGROUND: Current treatment of giant omphalocele includes "paint and wait" or placement of mesh or silo. These methods are associated with high complication rates. We propose negative pressure wound therapy as an alternative. METHODS: Patients born between 2009 and 2014 with giant omphalocele were included. Outcomes analyzed were duration of therapy, time to full enteral feeds, treatment related complications, wound surface area over time, type, and time to definitive closure...
March 2016: American Journal of Surgery
Erin A Miller, Adam Goldin, Geoffrey N Tse, Raymond Tse
Abdominal wall reconstruction ideally involves maintenance of domain by restoration of competent fascia and innervated muscle. Component separation allows closure of ventral hernias, but the technique is limited for high abdominal defects in the epigastric region. We describe an extended component separation that facilitated mobilization of the rectus abdominis muscle along its costal insertion to close an upper midline defect in a child with giant omphalocele, who had already undergone previous traditional component separation...
September 2015: Plastic and Reconstructive Surgery. Global Open
Marcial Oquendo, Vaidehi Agrawal, Roxana Reyna, Haroon I Patel, Mohammad A Emran, P Stephen Almond
OBJECTIVE: We successfully employed silver-impregnated hydrofiber dressing for management of giant omphaloceles (GO) followed by delayed surgical closure. STUDY DESIGN: Between 2005 and 2008, eight consecutive GO infants were cared for at Driscoll Children's Hospital. Four patients had additional congenital anomalies including Beckwith-Wiedemann (n = 1), tetralogy of Fallot (n = 1), pulmonary hypoplasia (n = 1), and ruptured omphalocele (n=1). Infants underwent amnion epithelization using a silver-impregnated hydrofiber dressing over the course of several months followed by delayed surgical closure...
October 2015: Journal of Pediatric Surgery
Weiwei Jiang, Jie Zhang, Xiaofeng Lv, Changgui Lu, Huan Chen, Xiaoqun Xu, Weibing Tang
BACKGROUND: The described surgical strategies for the management of omphalocele include primary closure, staged closure, and delayed closure. A primary repair is not suitable for all giant omphaloceles. We implanted two grafts, small intestinal submucosal (SIS) and acellular dermal matrix (ADM) onto abdominal wall defects in neonates to study the safety and efficacy of SIS and ADM graft techniques for initial closure of giant omphaloceles in infants, and we also implanted these grafts onto abdominal wall defects in an animal model...
March 2016: Journal of Pediatric Surgery
Anne Sophie Kruit, Sami A Al-Ani, Ingo Jester, Andrea Jester
Giant omphalocele is a rare, large abdominal wall defect in which the intra-abdominal organs herniate through the umbilical cord and are covered by a sac. Surgical management of giant omphalocele is challenging, and optimal treatment remains controversial. Two generally accepted treatment options are staged closure and delayed closure. Delayed closure takes place after a period of conservative treatment promoting omphalocele sac epithelialization. We present 3 patients treated by a delayed closure technique for ventral hernia repair...
June 2016: Annals of Plastic Surgery
Tanveer Akhtar, Anand Alladi, O S Siddappa
Omphalocele is a congenital abdominal wall defect that permits herniation of abdominal viscera into the umbilical cord. We here report a case of a giant omphalocele in an adolescent boy that has not been reported at this age before.
April 2015: Indian Journal of Surgery
Emily A Partridge, William H Peranteau, Alan W Flake, N Scott Adzick, Holly L Hedrick
PURPOSE: Giant omphalocele (GO) is a challenging problem owing to aberrant anatomy and complex comorbidities. Large inguinal hernias (IH) are known to occur in this population, but have not been well described in the literature. We sought to characterize rates and complications of IH in GO patients. METHODS: A retrospective chart review was performed on all patients with the diagnosis of GO from 2004 to 2012, with a minimum follow-up period of 12 months. Statistical significance was calculated using Fisher's exact test and Mann-Whitney test (p<0...
October 2015: Journal of Pediatric Surgery
Adesola C Akinkuotu, Fariha Sheikh, Oluyinka O Olutoye, Timothy C Lee, Cariciolo J Fernandes, Stephen E Welty, Nancy A Ayres, Darrell L Cass
BACKGROUND: The purpose of this study was to describe the current management and outcomes of infants with omphalocele. METHODS: The medical records of all patients treated for omphalocele at a large children's hospital from January, 2003-February, 2014 were reviewed. Patients were classified as having an isolated omphalocele or omphalocele with minor or major associated anomalies. Prenatal data collected included fetal magnetic resonance imaging-based observed-to-expected total fetal lung volumes...
October 2015: Journal of Surgical Research
William H Peranteau, Sasha J Tharakan, Emily Partridge, Lisa Herkert, Natalie E Rintoul, Alan W Flake, N Scott Adzick, Holly L Hedrick
PURPOSE: To evaluate the incidence, severity and duration of systemic hypertension in infants born with giant omphalocele (GO). METHODS: A retrospective review of patients born from 2003 through 2013 with a GO or intestinal atresia (control population) and managed at a single institution was performed. The hospital course was reviewed including all blood pressures, method of omphalocele repair, requirement for antihypertensive medications and renal function. RESULTS: Forty-five GO and 20 control patients met criteria for the study...
September 2015: Journal of Pediatric Surgery
Enrico Danzer, Marsha Gerdes, Jo Ann D'Agostino, Judy Bernbaum, Casey Hoffman, Natalie E Rintoul, Lisa M Herkert, Alan W Flake, N Scott Adzick, Holly L Hedrick
OBJECTIVE: To examine patient-specific factors as potential predictors of neurodevelopmental (ND) outcome in children with giant omphalocele (GO). MATERIALS: Between 06/2005 and 07/2012, 31 consecutive GO survivors underwent ND assessment using the BSID-III at a median of 24months (range 6-35). ND delay was defined by a score of ≤84 in any composite score. Severe impairments were defined as a score of ≤69 in at least one domain. Correlations between ND outcome and patient-specific factors were analyzed by one-way ANOVA, chi-square, or logistic regression as appropriate...
March 2015: Early Human Development
Emily A Partridge, Brian D Hanna, Howard B Panitch, Natalie E Rintoul, William H Peranteau, Alan W Flake, N Scott Adzick, Holly L Hedrick
BACKGROUND: Pulmonary hypoplasia has been described in cases of giant omphalocele (GO), although pulmonary hypertension (PH) has not been extensively studied in this disorder. In the present study, we describe rates and severity of PH in GO survivors who underwent standardized prenatal and postnatal care at our institution. METHODS: A retrospective chart review was performed for all patients in our pulmonary hypoplasia program with a diagnosis of GO. Statistical significance was calculated using Fisher's exact test and Mann-Whitney test (p<0...
December 2014: Journal of Pediatric Surgery
Felicia Drack, Alexander Mack, Walter Kistler, Bjarte Rogdo
No abstract text is available yet for this article.
2014: BMJ Case Reports
Lalit Parida, Kamalesh Pal, Hussah Al Buainain, Hossam Elshafei
Giant omphalocele is difficult to manage and is associated with a poor outcome. A male newborn presented to our hospital with a giant omphalocele. We performed a staged closure of giant omphalocele using synthetic mesh to construct a silo and then mesh abdominoplasty in the neonatal period that led to a successful outcome within a reasonable period of hospital stay.
September 2014: APSP Journal of Case Reports
Olivier Boucherat, Valérie Nadeau, Félix-Antoine Bérubé-Simard, Jean Charron, Lucie Jeannotte
The mammalian genome contains two ERK/MAP kinase genes, Mek1 and Mek2, which encode dual-specificity kinases responsible for ERK/MAP kinase activation. In order to define the function of the ERK/MAPK pathway in the lung development in mice, we performed tissue-specific deletions of Mek1 function on a Mek2 null background. Inactivation of both Mek genes in mesenchyme resulted in several phenotypes, including giant omphalocele, kyphosis, pulmonary hypoplasia, defective tracheal cartilage and death at birth. The absence of tracheal cartilage rings establishes the crucial role of intracellular signaling molecules in tracheal chondrogenesis and provides a putative mouse model for tracheomalacia...
August 2014: Development
Ayasa Nonaka, Nobuhiro Hidaka, Saki Kido, Kotaro Fukushima, Kiyoko Kato
A co-existing right congenital diaphragmatic hernia and omphalocele is rare. We present images of a fetus diagnosed with this rare combination of anomalies. Early neonatal death occurred immediately after full-term birth due to severe respiratory insufficiency. In this case, disturbance of chest wall development due to the omphalocele rather than the diaphragmatic hernia was considered as the main cause of lung hypoplasia. Our experience suggests that caution should be exercised for severe respiratory insufficiency in a neonate with an omphalocele and diaphragmatic hernia, even in the absence of an intra-thoracic liver, one of the indicators of poor outcome for congenital diaphragmatic hernia...
November 2014: Congenital Anomalies
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