What are the possible complications of pediatric omphalocele and gastroschisis (abdominal wall defects)?

Updated: Nov 05, 2019
  • Author: James G Glasser, MD, MA, FACS; Chief Editor: Dharmendra J Nimavat, MD, FAAP  more...
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Answer

Babies whose omphaloceles are treated conservatively ("paint and wait") have increased caloric requirements, because of their large open wound. Positive nitrogen balance is restored following skin closure.

Prolonged parenteral nutrition can cause hepatotoxicity, manifested by cholestasis and hepatomegaly, which may complicate a staged closure of a giant omphalocele. Omega-3 fatty acids (Omegaven) reportedly may reverse "intestinal failure associated liver disease."

Infants with giant omphaloceles have pulmonary hypoplasia in addition to diminutive thoraces; they may require tracheotomies and ventilatory support. Abdominal wall closure transiently increases intra-abdominal pressure; paradoxically, reconstituting the infant's torso improves muscular function and may enable ventilator weaning.

Infants with giant omphaloceles have an increased risk of sepsis, [21] because of the open wound and need for ventilatory support and central venous access.


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