Omphalocele - Treatment

Medical therapy in intact omphalocele.Newborns with omphalocele have other problems not intact, apart from associated pulmonary hypoplasia. Child requires intravenous administration of fluids, peritoneal sac should be covered with a membrane of Xeroform loose, then covered with Saran Kerlix and canvas. Omphalocele should be supported to avoid excessive traction on the mesentery.Prophylactic antibiotics should be administered preoperatively.Closing small omfalocelelor no problems.
Medical therapy of ruptured omphalocele.If breaking peritoneum covering their bodies outward inflammation can occur. The intestines may be normal or abnormal according to ischemic and inflammatory injuries suffered. Because exposure to the outside bodies thickens and shortens its fibrin and form a collagen membrane on the outside.
Thick and inflamed intestines are oedematous, chances are intestinal adhesions between them and the mesentery is short and congested. There are buildings with prolonged intestinal transit time and absorption function for low fat, carbohydrates and protein.After resolving inflammatory bowel function and peristalsis will be resumed for 4-6 weeks. During this time the child is fed parenterally.
Surgical therapy.Small omphalocele internalization is reduced by closing the defect and abdominal organs. Giant omphalocele involves circumferential incision made at the junction omphalocele, skin is left intact peritoneum, abdominal defect is extended to middle and rectus fascia is exposed from the pubis xifoid. Teflon tables are sutured along the edges up over the approximated fascia and omphalocele.
As is reduced, rectus muscle is higher than omphalocele. At the right time to remove tables Teflon omphalocele sac is excised and sutured a Gore-Tex membrane rectus fascia circumferential over.This is higher than for abdominal wall defect to be concave anterior abdominal. Leather strips are placed over the table. Gore-Tex require dressing covered with leather, while the AlloDerm is vascularized by the underlying liver. Can be left exposed and buffered antimicromiene topical. Like a wound that will epithelisant partially burned. Is an advantage, because it allows infection and replacing the dressing. AlloDerm is still rigid and ventral hernias cause a huge development that will require surgery and repair with rigid dressing.
Diet.Children with intact omphalocele presents normal bowel movements and require no special nutritional formulas. Intestinal atresia, if there is not associated with short bowel syndrome.
ComplicationsChildren may damage respiratory giant omphalocele requiring prolonged ventilatory support, tracheotomy or decanulare.
Prognosis.Patient's prognosis depends on the severity of associated diseases. Children with omphalocele are complex patients, which involves the presence of numerous defects. Giant omphalocele can be closed but through repeated surgeries. Factors affecting the survival of these children is diminished diameter of the chest cavity and respiratory problems resulting.