What is the approach to treatment of pediatric omphalocele?

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

Intestines within an intact omphalocele are protected from the amniotic fluid; hence, these babies tolerate feedings promptly after the abdominal wall defect is closed. Infants with giant omphaloceles, however, usually require prolonged hospitalization. Because their respiratory reserve is limited, reduction and closure in these babies should be accomplished gradually. "Paint and wait" is perhaps the safest approach: Topical antimicrobials are applied to the omphalocele membrane, and the infant's torso is wrapped with an elastic bandage (eg, ACE bandage). Healing occurs by epithelialization and wound contracture. These babies may require ventilatory assistance and tracheostomies.


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