Rare abdominal wall defect in newborn corrected

A newborn baby with a rare defect of abdominal wall with the abdominal organs lying outside the abdominal cavity,successfully underwent surgical correction on the first day of her birth,by neonatal and Paediatric surgeon Dr Kshama Kulkarni,at Sahyadri Hospital Hadapsar.

A newborn baby with a rare defect of abdominal wall with the abdominal organs lying outside the abdominal cavity (Omphalocoele major),successfully underwent surgical correction on the first day of her birth,by neonatal and Paediatric surgeon Dr Kshama Kulkarni,at Sahyadri Hospital Hadapsar.

Omphalocoele,also called as Exomphalous (meaning outside the abdominal cavity) is a rare congenital abdominal wall defect at the umbilicus,where the abdominal organs like the small and large intestine,liver,spleen & gonads lie outside the abdominal cavity,covered by a thin membrane. It affects approximately 1 among 5000 live babies,as in most cases babies with these defect either get aborted because of the severe abnormality or are sometimes mis-advised termination of pregnancy by the gynaecologists.

Kulkarni said,Normally this condition is diagnosed by ultrasonography during the ANC period itself,and if the foetus doesnt have any other chromosomal anomalies,the counselling of the parents regarding the mode of delivery (usually normal delivery) and the management of newborn baby after birth,should start since the time of diagnosis itself. The parents should be counselled by a team of doctors which includes a gynaecologist,Paediatric surgeon and Neonatologist,regarding the steps to be taken after delivery. Babies with this condition need to be operated within hours after birth,before the oedema of the intestine and devascularisation sets in.

During the surgery,the abdominal organs like small and large intestine along with a part of liver,which was lying outside the abdominal cavity,were replaced back into the abdominal cavity,the abdominal cavity was expanded to accumulate these organs and then cosmetic reconstruction of the umbilicus was done,thus completing the repair in single stage.The baby withstood the operation well,was kept nil per oral for around 4 days and on antibiotics,and then gradually started on feeds. At present,the baby is 12 days old and is fine,doctors said.

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