Sonographic biometry of liver and spleen size long after closure of abdominal wall defects
Antonio Zaccara1, Barbara D Iacobelli2, Edoardo La Sala2
1Newborn Surgery Unit, Bambino Gesu Children's Hospital, Piazza S. Onofrio 4, 00165, Rome, Italy. zaccara@opbg.net.
Insights
Patients with abdominal wall defects (AWD) who underwent surgery often have larger liver and spleen sizes post-operation. This study evaluated organ size in children and adolescents with a history of AWD closure.
Area of Science:
- Pediatric Surgery
- Abdominal Wall Defects
- Organometallics
Background:
- The long-term effects of abdominal wall defect (AWD) closure on liver and spleen size are not well understood.
- This knowledge gap complicates family counseling regarding follow-up care for patients with AWD.
Purpose of the Study:
- To evaluate the size of the liver and spleen in patients who underwent surgical closure of AWD at birth.
- To correlate organ size with anthropometric parameters and clinical features of the defect.
Main Methods:
- Ultrasound evaluation of liver size (index of liver size, ILS) and splenic volume (SV) in 18 patients (age 7-18 years).
- Correlation analysis with body mass index (BMI), weight, defect type, and closure method (direct or staged).
Main Results:
- Nearly all subjects had weight above and BMI below the 50th percentile for age.
- Liver and spleen size (ILS and SV) were significantly above normal limits in all evaluated patients.
- No significant difference in organ size was observed based on the type of AWD or closure method.
Conclusions:
- Patients who underwent surgical repair for abdominal wall defects typically exhibit enlarged liver and spleen dimensions.
- Despite increased size, the liver and spleen generally maintain their normal anatomical shape and position post-surgery.
Unlabelled:
Little is known about the fate of the liver and spleen after closure of the abdominal cavity in patients with abdominal wall defects (AWD). Therefore, counselling families for long-term follow-up and in the case of surgery for acute disease, pregnancy or trauma may be difficult. A total of 18 patients ranging in age from 7 to 18 years, with AWD closed at birth, underwent ultrasound evaluation of liver and spleen size by determination of the index of liver size (ILS) and splenic volume (SV). These values were then correlated with some anthropometric parameters such as body mass index (BMI) and weight; correlation was also sought with some clinical features such as type of defect and direct or staged closure. Nearly all subjects exhibited weight above and BMI below the 50th percentile for age. ILS and SV were significantly above normal limits in all cases and no difference was found with regard to the type of defect.
Conclusion:
In patients having undergone surgery for abdominal wall defects, liver and spleen usually regain their normal shape and position even though size and volume appear to be larger than in normal controls.