Abstract
Objective: To evaluate our experience on the pattern and treatment outcome of neonates who presented with congenital abdominal wall defects (CAWD) in a teaching hospital in Enugu, Nigeria. Methodology: This was a retrospective study of neonates who presented with abdominal wall defect of congenital origin between January 2014 and December 2018 at the pediatric surgery unit of Enugu State University Teaching Hospital (ESUTH) Enugu, Nigeria. Results: A total of 236,231 neonates were seen during the study period. Out of this number, 48 neonates had CAWD. This gave a prevalence of 0.02% or 2 babies per 10,000 births. There was male predominance and majority of the neonates were delivered preterm through the vaginal route. Omphalocele and gastroschisis were the most common CAWD and about 50% of the CAWD were diagnosed prenatally through maternal ultrasound. There was a low incidence of associated anomalies and only one-tenth of the mothers gave a history of a possible risk factor. Treatment of CAWD depended on the specific anomaly and sepsis was the most common post-operative complication. Mortality occurred in 8 (16.7%) neonates. Conclusion: Omphalocele and gastroschisis were the most common types of CAWD recorded in the present study. Most of the neonates were delivered vaginally as preterm babies. Treatment was based on the type of CAWD and majority of the neonates survived.
Highlights
Congenital abdominal wall defects (CAWD) refer to a spectrum of malformations of the abdominal wall that result from abnormal embryogenesis
Omphalocele and gastroschisis were the most common types of CAWD recorded in the present study
Treatment was based on the type of CAWD and majority of the neonates survived
Summary
Congenital abdominal wall defects (CAWD) refer to a spectrum of malformations of the abdominal wall that result from abnormal embryogenesis. It ranges from omphalocele to lethal limb-body wall syndrome [1]. CAWD is classified into omphalocele, gastroschisis, prune belly syndrome and limb-body wall syndrome. Prune–belly syndrome is an anomaly in which the abdominal wall is thin and lax revealing the intestinal pattern [3]. Limb-body wall syndrome, known as body stalk anomaly, is the rarest, most severe and invariably lethal abdominal wall defect. It is a severe defect in which the abdominal wall does not develop and the peritoneal cavity is open to the extraembryonic coelom and the fetus is attached to the placenta [4]. The aim of this study was to evaluate our experience on the pattern and treatment of neonates who presented with CAWD in a teaching hospital in Enugu, Nigeria
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