How is an intact pediatric omphalocele treated?

Updated: Nov 05, 2019
  • Author: James G Glasser, MD, MA, FACS; Chief Editor: Dharmendra J Nimavat, MD, FAAP  more...
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Infants with intact omphaloceles are usually not distressed; however, they should be carefully screened for associated problems, such as Beckwith-Wiedemann syndrome (which may cause hypoglycemia) or congenital heart disease, genetic abnormalities, or other malformations.

Maintenance intravenous (IV) fluids are administered, and the intact omphalocele sac is covered with a nonadherent dressing, such as Xeroform or Saran Wrap to preserve body heat and moisture.

Prophylactic antibiotics may be given preoperatively, if surgery for an associated intestinal anomaly is anticipated..

Closure of a small or moderate-sized omphalocele is usually accomplished without difficulty; however, infants with giant omphaloceles require staged surgery or "paint and wait", a nonoperative technique whereby topical antimicrobials are applied to the omphalocele sac (bacitracin or mupirocin), and the baby's torso is wrapped with an elastic bandage. This approach relies upon epithelialization of the omphalocele sac and wound contracture to obliterate the abdominal wall defect.

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