Premature Infant With Abdominal Wall and Proximal Lower Limb Defects

Abstract

A premature newborn was found to have a previously unknown lower abdominal defect. ### Prenatal and Birth Histories: ### Presentation: The infant had no respiratory effort at birth and was intubated in the delivery room. A large abdominal defect was noted, and stool was seen passing from a patent anus. Initial heart rate was 55 beats per minute. Positive pressure ventilation, surfactant, and chest compressions were administered without result. An emergency umbilical venous catheter was inserted, and the infant received 5 rounds of epinephrine and empiric bilateral thoracenteses before resuscitation was discontinued because of lack of response. The parents declined autopsy. ### Physical Examination: Postresuscitation examination revealed redundant skin over the scalp and neck. There was a 5-cm-long, transverse, full-thickness infraumbilical abdominal defect with liver and gallbladder exposed. The small intestine was completely eviscerated. Bilateral, symmetrical, 3-cm-long skin defects …