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[Conservative treatment of giant omphaloceles with dissodic 2% aqueous eosin: a case serie]
Trésor Kibangula Kasanga1, Tshiband Mosh Bilond1, Florent Tshibwid A Zeng1
1Département de Chirurgie, Faculté de Médecine, Cliniques Universitaires de Lubumbashi, Université de Lubumbashi, Province du Haut-Katanga, République Démocratique du Congo.
Insights
Conservative treatment using disodium aqueous eosin offers a promising alternative for giant omphalocele management, especially in resource-limited settings. This approach demonstrated positive outcomes without mortality in a small patient cohort.
Area of Science:
- Neonatal Surgery
- Pediatric Surgery
- Developmental Biology
Background:
- Giant omphalocele presents significant challenges with primary surgical closure, often leading to complications.
- Conservative management is a viable alternative, particularly in low-income regions with high neonatal mortality rates.
Observation:
- A prospective study evaluated conservative treatment of giant omphalocele using 2% aqueous eosin in three neonates.
- Patients received treatment within 48 hours of birth, with no prenatal diagnosis.
- The amniotic sac, containing the liver, had a mean diameter of 13.7 cm.
Findings:
- The median time to enteral feeding was 4.3 days, granulation occurred at a median of 31.7 days, and epithelialization at 71.7 days.
- No deaths were reported in the study cohort.
- The treatment protocol involved disodium aqueous eosin application.
Implications:
- Disodium aqueous eosin shows potential as an effective conservative treatment for unbroken giant omphaloceles.
- This method may reduce complications associated with surgical intervention in neonates.
- Further research is warranted to validate these preliminary findings in larger populations.
Abstract:
Primary surgical closure for the treatment of giant omphalocele is punctuated by the onset of unpleasant complications. Conservative treatment is an option in low-income countries where neonatal resuscitation is associated with high mortality rates. We conducted a prospective study of patients admitted to the University Clinics of Lubumbashi between January and April 2020 and receiving conservative treatment based on dissodic 2% aqueous eosin according to a defined protocol. Three patients were included in our series. The mean age was 24 hours (1 - 48); they were all full term newborns (38 - 39 SA), born vaginally and with no prenatal diagnosis. Mean birth weight was 2,800 grams (2,400 - 3,000). Mean amniotic sac diameter was 13.7 cm (11 - 15 cm); it contained the liver in all cases. The median time to enteral feed was 4.3 days (4 - 5 days), to granulation was 31.7 days (30 - 33 days) and to epithelialization was 71.7 days (60 - 90 days). No death was reported. These preliminary results encourage the use of disodium aqueous eosin for the conservative treatment of unbroken giant omphaloceles.
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