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Clinical characteristics and treatment of critical giant omphalocele
Author(s): Xu Lingling, Chen Huadong, Tang Wen, Liang Yujian, Liu Juncheng
Pages: 589-
592
Year: 2015
Issue:
9
Journal: New Chinese Medicine
Keyword: Giant omphalocele; Critical type; Epidermal growth factor; Non-surgical; Neonate;
Abstract: Objective To investigate the clinical characteristics and treatment of critical giant omphalocele.Methods Clinical data of 7 neonates diagnosed with critical giant omphalocele were retrospec-tively reviewed to analyze the clinical characteristics,treatment and clinical outcomes.One case with critical giant omphalocele was healed by administration of recombinant human epidermal growth factor (rhEGF)com-bined with conservative reduction of omphalocele contents.Results Seven neonates presented with abdominal defects with a diameter of 6-8 cm.The affected organs included liver,gallbladder,stomach and intestine.Five children were complicated with deformity and six with infection.Six cases had early abdominal closure and one had delayed abdominal closure.The time of abdominal closure ranged from 1 to 100 d and the time of mechani-cal ventilation was between 5 and 110 d.Five children were scheduled to undergo surgery,one received emer-gency surgery and one subjected to conservative therapy.Four patients died after surgery.One child who sur-vived required two-stage operation.One case was successfully healed by conservative therapy.This child was born at 35 +2 weeks with birth weight of 2.6 kg.The diameter of abdominal defect was 8 cm.The patient re-ceived trans-membrane suspension combined with reduction of omphalocele contents,and the junction skin be-tween the skin and cyst membrane was scraped daily and administered with rhEGF to accelerate skin growth.Disinfection and cyst membrane moisture were performed daily.At 15 weeks,cyst membrane was gradually re-placed by the skin and granulation tissues.The time of respirator use was only 18 d.Conclusions Critical gi-ant omphalocele is a severe disease,constantly complicated with deformity and infection.Surgical approach yields poor clinical efficacy.Combined therapy of use of rhEGF and reduction of omphalocele contents might be efficacious in treating critical giant omphalocele.
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