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Treatment of Ruptured Giant Omphalocele and Gastroschisis with Liver Herniation using a Wound Retractor as a Novel
Jana Nelson1, Robin Wachowiak1, Manuela Siekmeyer2
1Division of Pediatric Surgery, Leipzig University Hospital for Children and Adolescents, Leipzig, Saxony, Germany.
Insights
Ruptured giant omphaloceles and gastroschisis pose significant challenges. A staged surgical repair using a wound retractor silo effectively managed these complex cases, allowing for abdominal reduction and closure.
Area of Science:
- Pediatric Surgery
- Neonatal Care
- Congenital Abnormalities
Background:
- Ruptured giant omphaloceles (GO) and gastroschisis with total liver herniation represent rare, severe congenital abdominal wall defects.
- These conditions often lead to lethal outcomes due to the complexity of surgical and postsurgical management.
Observation:
- Two cases of infants with ruptured giant omphaloceles and gastroschisis involving total liver herniation were reported.
- The infants presented with exceptionally large abdominal wall defects.
Findings:
- A staged surgical repair technique utilizing a wound retractor as a silo was employed.
- This method facilitated the reduction of the liver and intestines into the abdominal cavity.
Implications:
- The described technique allowed for secondary closure of the abdominal cavity within the first 1-2 weeks of life.
- This approach offers a potential management strategy for complex abdominal wall defects in neonates.
- Successful management of these rare conditions can improve survival rates in affected infants.
Abstract:
Ruptured giant omphaloceles (GO) and gastroschisis with total liver herniation are rare cases of exceptionally large abdominal wall defects. Many of these children have lethal outcome. The surgical and postsurgical management are complex. We report on two cases treated with staged surgical repair using a wound retractor as a silo. With this technique, the liver and intestines could be reduced into the abdomen with secondary closure of the abdominal cavity within the first 1 to 2 weeks of life.
