Treatment of Ruptured Giant Omphalocele and Gastroschisis with Liver Herniation using a Wound Retractor as a Novel Approach

Nelson, Jana; Wachowiak, Robin; Siekmeyer, Manuela; Knuepfer, Matthias; Thomé, Ulrich; Stepan, Holger; Lacher, Martin

doi:10.1055/s-0040-1721054

Cited by 1 publication

(1 citation statement)

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“…1). 6 Cesarean section was performed before the onset of labor in the 38th week of gestation with Robson group 2b and intrauterine growth restriction. The birth weight was 2.9 kg.…”

Section: Case Reportmentioning

confidence: 99%

Successful on-ECLS Repair of CDH and Omphalocele in a Newborn

Fideler¹,

Mustafi²,

Kirschner

et al. 2023

European J Pediatr Surg Rep.

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Both congenital diaphragmatic hernias (CDHs) and omphaloceles show relevant overall mortality rates as individual findings. The combination of the two has been described only sparsely in the literature and almost always with a fatal course. Here, we describe a term neonate with a rare high-risk constellation of left-sided CDH and a large omphalocele who was successfully treated on extracorporeal life support (ECLS). Prenatally, the patient was diagnosed with a large omphalocele and a left CDH with a lung volume of ∼27% and an observed to expected lung-to-head ratio of 30%. Due to respiratory insufficiency, an ECLS device was implanted. As weaning from ECLS was not foreseeable, the female infant underwent successful surgery on ECLS on the ninth day of life. Perioperative high-frequency oscillatory ventilation and circulatory and coagulation management under point-of-care monitoring were the main anesthesiological challenges. Over the following 3 days, ECLS weaning was successful, and the patient was extubated after another 43 days. Surgical treatment on ECLS can expand the spectrum of therapy in high-risk constellations if potential risks are minimized and there is close interdisciplinary cooperation.

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“…1). 6 Cesarean section was performed before the onset of labor in the 38th week of gestation with Robson group 2b and intrauterine growth restriction. The birth weight was 2.9 kg.…”

Section: Case Reportmentioning

confidence: 99%