Successful resection of delayed management rupture midline encephalocele: A case report
Stefani Miranda1, Aminuddin Harahap2, Amiril Mu'minin3
1Faculty of Medicine, Hang Tuah University, Komplek Barat RSPAL dr. Ramelan, Jalan Gadung No. 1, Surabaya, Jawa Timur 60111, Indonesia; Department of Child Health, dr. Ramelan Navy Central Hospital, Jalan Gadung No.1, Surabaya, Jawa Timur 60244, Indonesia.
Insights
Prompt surgical intervention for ruptured encephalocele is crucial. Early corrective surgery in infants, especially for exposed neural tube defects (NTDs), ensures optimal outcomes and prevents complications.
Area of Science:
- Pediatric Neurosurgery
- Neural Tube Defects (NTDs)
Background:
- Encephalocele, a type of NTD, occurs in 1 in 10,000 live births.
- Prompt surgical repair is recommended within 48 hours for ruptured encephaloceles.
- Infection signs must be considered during corrective surgery.
Observation:
- An 8-day-old infant presented with a ruptured midline frontoparietal encephalocele due to delayed surgery.
- The encephalocele measured 7x6x5 cm with fluid leakage.
- CT scan showed a protruding, ill-defined mass from the anterior fontanelle.
Findings:
- Emergency corrective surgery involved complete excision and watertight double-layer closure.
- The patient experienced an uneventful postoperative recovery.
Implications:
- Encephalocele requires surgical resolution.
- Timely surgical closure of defects, particularly those lacking skin protection, is vital.
- This case highlights the successful management of a ruptured encephalocele through emergency surgery.
Introduction And Importance:
Encephalocele is an NTD that affects one in every 10,000 live births. A ruptured encephalocele is advised to be operated on as soon as possible, preferably within 48 h. Signs and symptoms of infection should be considered when performing corrective surgery.
Case Presentation:
We present the case of an 8-day-old baby who had a ruptured midline frontoparietal encephalocele as a result of delayed corrective surgery. The mass on the patient's head measured approximately 7 × 6 × 5 cm with a leakage of clear and yellowish fluids. The head CT scan revealed a multi-enhancement mass, pedunculated with an ill-defined border protruding from the anterior fontanelle.
Clinical Discussion:
The patient underwent an emergency corrective surgery. Excision was performed completely. The defect was covered with a double-layer closure technique in a watertight manner. The patient's postoperative recovery was uneventful.
Conclusion:
An encephalocele can only be resolved through corrective surgery. In our case, the ruptured midline encephalocele was easily resolved with an emergency corrective surgery. Closure of the defect soon after birth is advised, especially if no layer of skin protects the encephalocele.
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