Giant omphalocele treated with simple daily dressing changes

Abstract

Omphalocele, also called exomphalos, is an anterior abdominal wall midline defect of variable size involving the umbilical ring containing the herniated viscera into a sac made up of peritoneum, amnion and Wharton's jelly. Giant omphalocele is an extreme version of this defect management of which is challenging. Author is reporting here a case of giant omphalocele managed initially by a simple yet novel conservative technique yielding subsequently good result. • Although no standard definition of GO exists, some authors consider the malformation to be a giant omphalocele (GO) when the abdominal wall defect exceeds 5–6 cm in diameter and the sac contains the whole or most of the liver. • Numerous methods for managing giant omphaloceles have been described since ages, but however, still there is no standard definition as well as its universal way of is management. • Since many GOs cannot be closed at birth due to various reasons, better to manage initially with non operatively with topical agents to facilitate epithelialization of the sac by dry eschar formation promoting subsequent scar tissue leaving behind small umbilical defect as the baby grows. • A technique of dry desiccated antiseptic and antibiotic dressings with graduated compression pressure applied daily is a simple yet innovative method of dealing with morbid congenital anomaly called giant omphalocele, yielding subsequently good results with perseverance from the involved medical team without any morbidity or mortality.