Antenatal diagnosis and perinatal care of anterior abdominal wall defects

1995 ◽  
Vol 7 (3) ◽  
pp. 109-127 ◽  
Author(s):  
Hratch L Karamanoukian ◽  
Stuart J O'Toole ◽  
Philip L Glick
Keyword(s):  
Parenteral Nutrition ◽  
Abdominal Wall ◽  
Antenatal Diagnosis ◽  
Anterior Abdominal Wall ◽  
Wide Spectrum ◽  
Perinatal Care ◽  
Postoperative Management ◽  
Abdominal Wall Defects ◽  
Anaesthetic Care ◽  
Prognostic Implications

Improvements in anaesthetic care and postoperative management over the last two decades have significantly improved survival of neonates with ventral abdominal wall defects, from a dismal 47% in 1971, to 96% for both gastroschisis and isolated omphalocele in two recent series. This increased survival has generally been attributed to result from improvements in the pre and postoperative management of these fragile neonates. Specifically, the routine use of total parenteral nutrition, and staged repairs for cases with severe “viscero-abdominal disproportion” have been implicated in a decreased incidence of sepsis, morbidity and mortality. In addition, an appreciation of the wide spectrum of anomalies uniquely associated with gastroschisis and omphalocele have helped improve survival, as each has unique pathophysiologic features that have prognostic implications for the fetus before, during and after delivery.

scholarly journals Current issues of diagnosis and treatment of neonatal omphalocele

2020 ◽  
Vol 23 (2) ◽  
pp. 126-131
Author(s):  
Анна Александровна Щукина ◽  
Ольга Геннадьевна Мокрушина ◽  
Александра Сергеевна Гурская ◽  
Елена Юрьевна Дьяконова
Keyword(s):  
Surgical Treatment ◽  
Abdominal Wall ◽  
Antenatal Diagnosis ◽  
Anterior Abdominal Wall ◽  
Abdominal Cavity ◽  
Dynamic Control ◽  
Postoperative Management ◽  
Unified Approach ◽  
Hernia Sac ◽  
Respiratory Parameters

The review of topical issues of diagnostics and treatment of malformation of the anterior abdominal wall - omphalocele in newborns is presented. Currently, there are no specific, recognized criteria acceptable for the maintaining and further managing pregnancy, delivery and treatment of children with omphalocele. Prenatally, the possibility of predicting the tactics of surgical treatment and postoperative management of a newborn with omphalocele is not taken into account. In the choice of tactics of treatment of this category of patients there is a need to consider many factors, namely: the data for the antenatal diagnosis of the defect, duration of respiratory support at the stage of preparation for surgery, age at the time of surgical treatment, the size of the hernia SAC, and the size of the liver in the hernia SAC. These criteria are necessary to determine the possibility of radical surgery for the anterior abdominal wall or stage-by-stage treatment with the creation of a temporary abdominal cavity, with preliminary gradual immersion of the evented organs into the abdominal cavity under the control of the child’s hemodynamic and respiratory parameters, with the dynamic control of the occurrence and progression of pulmonary hypertension under the ultrasound control. To date, a unified approach has not been developed in the surgical treatment and postoperative care of newborns with omphalocele. The use of a variety of methods of surgical correction and their modifications reveals extensive potential for the treatment of different form of exomphalos, but leads to the fact that some of these techniques find their applications in a single universally accepted treatment of this condition. The lack of unified standards of prevention and organization of treatment approaches for newborns with various forms of omphalocele makes this problem very relevant. When preparing a literary review, such databases as PubMed, MedLine, CyberLeninka, and RSCI were used.

How good is ultrasound in the detection and evaluation of anterior abdominal wall defects?

1992 ◽  
Vol 65 (772) ◽  
pp. 298-301 ◽  
Author(s):  
S. A. Walkinshaw ◽  
M. Renwick ◽  
G. Hebisch ◽  
E. N. Hey
Keyword(s):  
Abdominal Wall ◽  
Anterior Abdominal Wall ◽  
Abdominal Wall Defects

Acute fluid volume requirements in infants with anterior abdominal wall defects

1972 ◽  
Vol 7 (5) ◽  
pp. 553-558 ◽  
Author(s):  
Arvin I. Philippart ◽  
Timothy G. Canty ◽  
Robert M. Filler
Keyword(s):  
Abdominal Wall ◽  
Anterior Abdominal Wall ◽  
Fluid Volume ◽  
Abdominal Wall Defects

scholarly journals Meconium contaminated amniotic fluid leads to intestinal wall thickness and affects the functional outcome of abdominal wall defects

2019 ◽  
Author(s):  
Melanie Kapapa ◽  
Teresa Rieg ◽  
Alexandre Serra
Keyword(s):  
Mechanical Ventilation ◽  
Parenteral Nutrition ◽  
Amniotic Fluid ◽  
Hospital Stay ◽  
Functional Outcome ◽  
Abdominal Wall ◽  
Wall Thickness ◽  
Intestinal Wall ◽  
Oral Feeding ◽  
Abdominal Wall Defects

Abstract Background: We analysed abdominal wall defect patients over an 11-year period, aiming to assess the influence of meconium-contaminated amniotic fluid . Meconium-contaminated amniotic fluid leading to intestinal wall thickness and impairs surgical and functional outcome. Methods: A retro- and prospective, observational case- control design was used to compare gastroschisis (n=36) and omphalocele (n=18) children. Physical data, color of amniotic fluid, pre- and perinatal problems, operative complications and surgical technique, postoperative complications, duration of ICU stay, mechanical ventilation, parenteral nutrition, begin of oral feeding and total hospital stay were collected. Data was analyzed with descriptive methods, t-test and non-parametric tests such as Wilcoxon and Kruskal-Wallis were performed in addition to ANOVA, including post-hoc testing accepting a confidence interval of 95% (p<0.05) by using IBM SPSS software, version 23 (IBM, Illinois, USA). Results: Rate of meconium-contaminated amniotic fluid is significantly higher in GS compared to OC, delivery problems are also significantly higher, this yields in significantly more bowel loops anomalies and problems during surgery but had no significant influence on primary abdominal wall closures rate. The post-surgical outcome of OC was significantly better compared to GS. Within the GS, those with swollen intestines had significantly longer ICU stays due to extended mechanical ventilation, parenteral nutrition and delayed initiation of oral feeding. Same results were found for secondary closures compared to primary abdominal wall closures in GS group. Conclusions: Worsen functional short-term outcome of GS children was directly addicted to meconium contamination of amniotic fluid due to swollen intestines and because of this more post-surgical problem including significantly extended hospital stay were observed.

scholarly journals Complex treatment of a patient with multiple external intestinal fistulas after pancreatoduodenal resection

1997 ◽  
Vol 78 (1) ◽  
pp. 52-53
Author(s):  
A. L. Lomonosov ◽  
Yu. S. Sokolov ◽  
A. A. Golubev ◽  
A. G. Eremeev ◽  
S. P. Bondarenko ◽  
...  
Keyword(s):  
Parenteral Nutrition ◽  
Abdominal Wall ◽  
Anterior Abdominal Wall ◽  
Postoperative Mortality ◽  
Economic Conditions ◽  
Complex Treatment ◽  
Complex Therapy ◽  
Intestinal Fistulas ◽  
Enteral And Parenteral Nutrition ◽  
Overall Mortality

The urgency of the problem of treatment of unformed external intestinal fistulas (UIE) is beyond doubt, since the overall mortality ranges from 2.8% to 34%, and postoperative mortality reaches 72%. The necessity of a complex therapy, the choice of elements of which is determined in each specific case, has been substantiated. An important component of this complex is measures to create and maintain hyperalimentation by combining various options of enteral and parenteral nutrition, which is the most acceptable in difficult economic conditions. Closure of large defects of the anterior abdominal wall seems to be no less important problem of NSCLC treatment and requires searching for new approaches in its solution.

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