Omphalocele/Gastroschisis

2018 ◽  
Author(s):  
Karla E. K. Wyatt ◽  
Olutoyin A. Olutoye
Keyword(s):  
Abdominal Wall ◽  
Abdominal Wall Defect ◽  
Perioperative Complications ◽  
Anesthetic Management ◽  
Management Strategies ◽  
Abdominal Wall Defects ◽  
Wall Defect ◽  
Goal Maintenance ◽  
Surgical Closure ◽  
Fluid Losses

Omphalocele and gastroschisis are the most common types of abdominal wall defects encountered in the neonatal population. Both conditions result in the herniation of abdominal viscera through a defect in the upper or lower abdominal wall. These neonates can present with herniated organs, intestinal obstruction, impaired blood supply to visceral organs, and major fluid deficits. The primary goal for a neonate with an abdominal wall defect is surgical closure. Prior to achieving this goal, maintenance of perfusion of the herniated viscera and minimization of evaporative fluid losses secondary to the exposed surface area are paramount. This chapter discusses the distinctly different etiologies of these conditions, comorbidities, and prognoses, as well as the surgical and anesthetic management strategies and commonly encountered perioperative complications.

Left-Sided Gastroschisis

2006 ◽  
Vol 72 (7) ◽  
pp. 637-640 ◽  
Author(s):  
Kenneth W. Gow ◽  
Amina Bhatia ◽  
Daniel F. Saad ◽  
Mark L. Wulkan ◽  
Kurt F. Heiss
Keyword(s):  
Abdominal Wall ◽  
Clinical Course ◽  
Abdominal Wall Defect ◽  
Abdominal Wall Defects ◽  
Wall Defect ◽  
The Right

Gastroschisis is a periumbilical, abdominal wall defect arising to the right of the umbilicus. We describe the clinical course of a left-sided gastroschisis in a term female born at 39 weeks’ gestation. To our knowledge, there have been only 14 left-sided abdominal wall defects reported in the literature. We discuss our case and review the literature to try to determine if there is any clinic difference between right- versus left-sided lesions to make recommendations as to management.

scholarly journals The Oscar Ramirez Procedure, a Solution for Treating Incisional Hernias with Big Abdominal Wall Defect

2014 ◽  
Vol 60 (3) ◽  
pp. 122-124
Author(s):  
M. Gherghinescu ◽  
D. Popa ◽  
A. Panțiru ◽  
C. Russu ◽  
C. Roșca ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Abdominal Wall Defect ◽  
Postoperative Recovery ◽  
Oblique Muscle ◽  
Abdominal Wall Defects ◽  
Hernia Sac ◽  
Wall Defect ◽  
External Edge ◽  
Incisional Hernias ◽  
Bowel Movements

Abstract Background: Incisional hernias are important complications of abdominal surgery. Normally they are followed by the growth of the hernia sac and an increase of the abdominal wall defect with loss of domain of the herniated organs. Case report: We report a case of a 51 year old female, admitted in the 1st Surgical Clinic of the County Emergency Clinical Hospital of Tîrgu Mureș with a large median reducible incisional hernia and a wall defect of 10/12 cm. The abdominoplasty was performed using the Oscar Ramirez technique, which consists of a longitudinal incision along the aponeurosis of the external oblique muscle, at approximately 1-2 cm from the external edge of the rectus abdominis. This procedure allows the abdominal wall closure. This case is part of a lot of 4 patients who received this treatment using the aforementioned procedure in the past 2 months. Postoperative recovery was favorable, bowel movements were present on the second day after the surgery, the subcutaneous drains were shortened on the fifth day and removed on the sixth. There were no immediate postoperative complications or up to a month after the surgery. The patient was discharged on the seventh day. Conclusions: This technique can be used alone in case of large abdominal wall defects, or prequeling an on-lay mesh procedure addressed to a weak abdominal wall, case in which the functional result is superior to a substitutional mesh.

scholarly journals Rectus Abdominis Muscle Malignant Fibrous Histiocytoma Causing a Large Abdominal Wall Defect: Reconstruction with Biological Mesh

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Evangelos Falidas ◽  
Stavros Gourgiotis ◽  
Christina Goudeli ◽  
Stavros Mathioulakis ◽  
Konstantinos Vlachos ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Abdominal Wall ◽  
Malignant Fibrous Histiocytoma ◽  
Fibrous Histiocytoma ◽  
Abdominal Wall Defect ◽  
Biological Mesh ◽  
Rectus Abdominis ◽  
Abdominal Wall Defects ◽  
Rectus Abdominis Muscle ◽  
Wall Defect

Malignant fibrous histiocytoma (MFH) is a common soft tissue sarcoma usually involving limbs and retroperitoneum. MFH of the rectus abdominis muscle is extremely rare. Surgery in similar cases leads to large abdominal wall defects needing reconstruction. Biological and synthetic laminar absorbable prostheses are available for the repair of hernia defects in the abdominal wall. They share the important feature of being gradually degraded in the host, resulting the formation of a neotissue. We herein report the case of an 84-year-old man with MFH of the rectus abdominis muscle which was resected and the large abdominal wall defect was successfully repaired with a biological mesh.

One of Curious Congenital Midline Abdominal Defects In Newborn: A Giant Omphalozele In A 3 Years-Old Boy

2021 ◽  
Author(s):  
Stefan Bittmann
Keyword(s):  
Abdominal Wall ◽  
Abdominal Wall Defect ◽  
Abdominal Wall Defects ◽  
Wall Defect ◽  
Lateral Abdominal Wall ◽  
The Third ◽  
Abdominal Organs ◽  
Wall Components ◽  
Congenital Abdominal Wall Defects

Omphalocele is one of the congenital abdominal wall defects and specifically refers to an umbilical ring defect in which the abdominal organs protrude in front of the abdominal wall in a thin sac or membrane. Such an abdominal wall defect develops around the third week of pregnancy due to the failure of adhesion between the embryonic lateral abdominal wall components.

scholarly journals Use of alloplastic meshes in abdominal wounds of rats with induced peritonitis

2014 ◽  
Vol 27 (1) ◽  
pp. 26-29 ◽  
Author(s):  
Rafael Calvão BARBUTO ◽  
Ivana DUVAL-ARAUJO ◽  
Sumara Marques BARRAL ◽  
Raphael Grossi ROCHA ◽  
Cristiane de Souza BECHARA ◽  
...  
Keyword(s):  
Tensile Strength ◽  
Abdominal Wall ◽  
Granulation Tissue ◽  
Abdominal Wall Defect ◽  
Test Group ◽  
Microscopic Analysis ◽  
Female Rats ◽  
Control Group ◽  
Abdominal Wall Defects ◽  
Wall Defect

Background : The use of alloplastic meshes has been historically contra-indicated in patients with infection. Aim : To evaluate the use of polypropylene meshes in the treatment of abdominal wall defects in rats with peritonitis. Methods : Twenty Wistar female rats were divided into two groups: induction of peritonitis (test group) and without peritonitis (control group). An abdominal wall defect was created in all animals, and polypropylene mesh was applied. The evaluation of the tensile strength of the mesh was carried out using tensiometer and microscopic analysis of the healing area was done. Results : More adhesion of the mesh to the rat abdominal wall was observed in test group. The histopathological analyses showed prevalence of moderate to accentuated granulation tissue in both groups, without significant differences. Conclusion : The use of the mesh coverage on abdominal wall defects of rats with induced peritonitis did not show worse results than its use in healthy animals, nor was its integration to the resident tissue any worse.

scholarly journals Abdominal wall repair with human acellular dermal autograft

2011 ◽  
Vol 2 (1) ◽  
pp. 6
Author(s):  
Roel E. Genders ◽  
Paul P.G.M. Kouwenberg ◽  
Rob P. Bleichrodt
Keyword(s):  
Abdominal Wall ◽  
Abdominal Wall Defect ◽  
Operative Procedure ◽  
Abdominal Wall Defects ◽  
Dermal Matrix ◽  
Wall Defect ◽  
Mortality And Morbidity ◽  
Acellular Dermis ◽  
Number Of Patients ◽  
Acellular Dermal

Repair of abdominal wall defects in the presence of contamination or infection is a significant problem. The loss of tissue warrants enforcement of the abdominal wall, preferably by autologous material. However, autologous repair often requires extensive surgery. This paper presents a review of available literature of placement of an acellular human dermis to repair an abdominal fascia defect, in contaminated as well as in non-contaminated surgical fields. It is illustrated with a case report that describes the successful reconstruction of an infected abdominal wall defect with a human acellular dermis allograft. A systematic literature review was undertaken with searches performed in the Pubmed and Cochrane databases for the period up till March 2009, using the search terms <em>Alloderm</em> [Substance Name], <em>Hernia</em> [Mesh] and the key words <em>acellular dermis, acellular dermal matrix, human acellular dermal allograft </em>and <em>abdominal wall defect</em>. To assess methodological quality, each article was subjected to a modification of the methodological index for non-randomized studies (MINORS) according to Slim <em>et al.</em> Two items from the original index were not included because none of the studies selected had an unbiased assessment of the study end points and in none of the studies was a prospective calculation of the study size performed. Seventeen studies were included in the review. Data were extracted regarding study design, number of patients, surgical technique, followup period, contaminated or non-contaminated area of the fascia defect, mortality and morbidity (hemorrhage, seroma, wound dehiscence, infection) of the operative procedure, the longterm results (removal of the graft, reherniation and bulging) and level of evidencey. A total of 169 short-term complications and 151 longterm complications occurred after 643 surgical procedures reconstructing both contaminated and clean abdominal wall defects by implantation of an HADA. Human acellular dermal allograft seems to be a good alternative for autologous repair of contaminated or infected abdominal wall defects.

scholarly journals Investigation of a connection between abdominal wall defects and severity of the herniation in fetuses with gastroschisis and omphalocele

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Natasha T. Logsdon ◽  
Carla M. Gallo ◽  
Luciano Alves Favorito ◽  
Francisco J. Sampaio
Keyword(s):  
Abdominal Wall ◽  
Iliac Crest ◽  
Abdominal Wall Defect ◽  
Control Group ◽  
Abdominal Wall Defects ◽  
Internal Organs ◽  
Wall Defect ◽  
Mean Values ◽  
Biometric Parameters ◽  
Post Test

AbstractAnalyze the biometric parameters and the size (area) of abdominal wall defect (AWD) in fetuses with gastroschisis and omphaloceles and correlate them with the herniated internal organs. We studied 22 fetuses (11 with AWDs and 11 without anomalies). In all fetuses we evaluated the xiphopubic distance (XPD) and iliac crest distance (ICD). In fetuses with AWDs we dissected the abdominal wall and measured the width and length of the defect for calculating its area and studying the correlation between the size of the defect with the organs that were herniated. For statistical analysis, the Anova and Tukey post-test were used (p < 0.05). The XPD in the control group had mean of 4.2 mm (2.3–5.9; SD ± 1.11), while in the AWDs it was 4.2 mm (2.9–5.5; SD ± 0.98) (p = 0.4366). The ICD had mean values of 2.5 mm (1.6–3.4; SD ± 0.58) in the control group, and 2.3 mm (1.2–3.0; SD ± 0.56) in AWDs fetuses (p = 0.6963). The number of herniate organs do not have significant correlation with the area of the defect (r2 = 0.2504, p = 0.5068). There is no correlation between the size (area) of abdominal wall defects and the number of the internal organs that herniated. Therefore, the hole size is not a predictor of the severity of the gastroschisis or omphalocele.

scholarly journals MAIN PRINCIPLES OF ETIOPATHOGENETIC TREATMENT OF NEWBORNS WITH GASTROSCHISIS

2021 ◽  
Vol 11 (1(39)) ◽  
pp. 6-12
Author(s):  
Olga Gorbatyuk ◽  
K.T. Bertsun ◽  
O.S. Rubina ◽  
R.O. Gomon
Keyword(s):  
Early Diagnosis ◽  
Abdominal Wall ◽  
Abdominal Wall Defect ◽  
Anesthetic Management ◽  
Surgical Correction ◽  
Intraabdominal Pressure ◽  
Preoperative Preparation ◽  
Wall Defect ◽  
Intraabdominal Hypertension ◽  
High Level

Introduction. The paper focuses on the challenging issue of treatment of newborns with gastroschisis (GS) and a high level of intraabdominal hypertension in case of severe viscero-abdominal disproportion. The aim of the paper is to present the current state of the problem at the regional level based on our own clinical experience in observation and treatment of newborns with GS. Material and methods. The study is based on the analysis of examination and treatment of 29 newbornswith GS. The distribution of boys and girls was nearly the same: 16 (55.17%) boys and 13 (44.83%) girls. The number of premature babies was 23 (79.31%). The complex of diagnostic procedures included clinical laboratory examination, radiologic investigation (using contrast agents when required), ultrasound investigation and Doppler sonography, intraabdominal pressure measurement, histologic study of surgical specimens.Results. Prenatal information on the congenital anterior abdominal wall defect was obtained with the help of prenatal ultrasound. In most cases, fetal GS is diagnosed before 20 weeks of pregnancy. Prenatal ultrasound was performed in 13 (44.83%) pregnant women out of the researched group. Two false test results were obtained.Radiologic investigation of a child with GS is necessary to detect intestinal obstruction, necrosis or bowel perforation. Among patients under our study, two cases of ileal atresia were registered. The analysis of intraabdominal pressure indices in patients with GS showed a high level of intraabdominal hypertension in approximately 70% of cases. It proves that patients with GS have a high level of surgical and anesthetic risk. The main therapy measures include the following steps: appropriate preoperative preparation, anesthetic management, and the choice of appropriate perioperative techniques taking into account the level of intraabdominal hypertension and viscero-abdominal disproportion.Depending on the child's condition, type of GS and level of intraabdominal hypertension, there were twosurgical options:1. Primary radical surgery.2. Staged surgical treatment.Analyzing the results of the study, it may be noted that 8 newborns in total died after the surgery, which is 27.59%(it used to be 56-60% till 2005). The main causes of death were respiratory failure, neonatal sepsis and unfavorable premorbid conditions (very low gestational age, severe comorbidity, multiple congenital malformations).Conclusions. 1. Successful treatment of newborns with GS depends on the early diagnosis of the pathology, which must be prenatal, and elimination of contradictions in treatment tactics. 2. Before suturing the abdominal wall defect in newborns with GS, it is necessary to measure intraabdominal pressure, since intraabdominal hypertension leads to a significant deterioration in the mechanical properties of the lungs, hemodynamic abnormalities,oliguria, intestinal ischemia, decrease in organ perfusion, which must be taken into account when carrying out preoperative preparation and aesthetic management. 3. The level of intraabdominal hypertension in patients with GS,which is high in 68.96% of cases, must be an indication for choosing the method of surgical correction of the defect i.e.the refusal of radical plasty of the abdominal wall and the resort to staged intervention or other surgical techniquesthat involve an increase in the abdominal cavity volume. 4. The reduction in mortality in newborns with GS to 27.59%is possible due to the introduction of etiopathogenetic approaches to early diagnosis, preoperative management, anesthetic management and surgical correction of this pathology into the practice of neonatal surgery.

scholarly journals Comparative Cellular Local Response in Abdominal Defect Plastic Surgery with Bovine Pericardium and Bovine Fascia Preserved in Formaldehyde in Experimental Rabbits

2017 ◽  
Vol 23 (2) ◽  
pp. 83-93
Author(s):  
Eva Gudemac ◽  
S. Babuci ◽  
C. Tica ◽  
V. Petrovici ◽  
V. Nacu ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Direct Contact ◽  
Anterior Abdominal Wall ◽  
Abdominal Wall Defect ◽  
Bovine Pericardium ◽  
Congenital Defects ◽  
Abdominal Wall Defects ◽  
Wall Defect ◽  
Fascia Graft ◽  
Subcutaneous Layer

AbstractIn the present paper, we refer to a method of primary closure of congenital defects of the anterior abdominal wall with tensionless viscero-abdominal disproportion. The study group included 10 animals subjected to surgery of the abdominal wall defect closure with bovine pericardium graft preserved in 0.5% formaldehyde, and 5 rabbits of the same breed and weight, in which bovine fascia graft was used as implant, being preserved in 0.5% formaldehyde. The abdominal anterior wall defect was made surgically by excision of the musculo-fascial structures and peritoneum. Bovine pericardium graft and bovine fascia graft were placed and fixed posteriorly to rectus abdominals muscles, having direct contact with the intra-abdominal contents and protected by suturing skin and subcutaneous layer.The purpose of the study was to perform a comparative postoperative evaluation of local macroscopic and microscopic changes that develop after reconstruction of the major abdominal wall defects experimentally induced in rabbits, using bovine pericardium and bovine fascia grafts preserved in 0.5% formaldehyde.In cases of major fascial defects of the anterior abdominal wall, bovine pericardium graft has acceptable strength and biocompatibility, having stabilizing properties of the abdominal wall due to the development of the connective tissue layer located between the implant and the subcutaneous layer. Bovine fascia grafts preserved in formaldehyde have an insignificant irritating and inflammatory action on the intestinal loops compared with bovine pericardium, and do not induce the development of a significant abdominal adhesion process, this allowing their use in the abdominal fascial defects closure with placement in direct contact with the abdominal contents.

Anesthesia for Gastroschisis or Omphalocele Repair

2021 ◽  
pp. 215-220
Author(s):  
Caitlin Aveyard
Keyword(s):  
Abdominal Wall ◽  
Amniotic Membrane ◽  
Chromosomal Abnormalities ◽  
Abdominal Wall Defect ◽  
Anesthetic Management ◽  
Surgical Correction ◽  
Congenital Defects ◽  
Full Thickness ◽  
Wall Defect ◽  
The Right

Gastroschisis and omphalocele are congenital defects in the abdominal wall. These two conditions have different embryologic origins, but anesthetic management is similar for both. Gastroschisis is a full-thickness abdominal wall defect resulting in extrusion of abdominal viscera into the amniotic space without amniotic membrane coverage. The defect is usually to the right of the umbilicus. Omphalocele is a defect in the abdominal wall in the umbilical area in which the extruded abdominal contents (intestine, liver, spleen, bladder) are covered in a thin sac. Infants with omphalocele often have associated syndromes or chromosomal abnormalities. With either gastroschisis or omphalocele, the extruded abdominal contents must be covered and kept moist before surgical correction.

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