Omphalocele

Abstract

Omphaloceles vary from several centimeters to 15 cm. in diameter. The thin membrane may be intact or ruptured when the surgeon sees the baby. Immediate surgery is advised. An anatomic closure can be accomplished with the smaller defects. Only skin closure and partial approximation of the rectus muscles and fascia should be accomplished if there is the slightest suggestion that the liver and intestines will be compressed by suturing the wound in layers. The frequency of associated anomalies is well established and when possible they should be corrected at the initial operation. Even under ideal circumstances the mortality rate is about 35 per cent. Usually the outcome will be successful if the following conditions exist: (1) The surgeon is experienced in handling pediatric surgical problems including complete preoperative and postoperative care. (2) The diameter of the omphalocele is not too great and the liver does not extend very far into the sac. (3) The time interval from birth to surgery is only a few hours. (4) The sac is intact when the infant reaches the operating room. (5) There are no serious cardiac or other congenital anomalies which cannot be corrected. (6) The birth weight is five pounds or more. © 1961.