A PICC line is placed. TPN is started. Ampicillin and Gentamycin continue while a
silo is in place. Final closure is usually achieved 7-10 days after the silo is initially
placed.
VII. OMPHALOCELE
An omphalocele is a congenital defect of the anterior abdominal wall
characterized by herniation of varying amounts of uncovered viscera (including liver)
into an avascular sac consisting of fused amnion and peritoneum. If a “giant”
omphalocoele (>5 cm), C-section is warranted
Incidence of omphalocele is ~ 1 in 6,000-10,000 live birthsLike gastroschisis, omphaloceles are now most commonly diagnosed prenatally.
Unlike gastroschisis, the defect is contained within umbilical cord, unless ruptured. Even
in small sized omphaloceles, the bowel is nonrotated. In the large omphaloceles, there
usually is a globular liver within the sac.
Associated anomalies seen in at least 50% of cases: These include
Cardiac
Tetralogy of Fallot, VSD
PS, coarctation, AV canal
Neurological
Genitourinary
Imperforate anus