Omphalocele

[size=6]A term infant weighing 2.5kg is born with a giant omphalocele measuring 6cm in diameter and containing 65% of the total liver volume. Other than a small muscular ventricular septal defect, there are no other associated anomalies. The amnion is still intact, but the defect is too large to be closed primarily. After a case conference to discuss staged closure options, a decision is made to gradually reduce the herniated contents with a silo created from an adhesive, hydrocolloid dressing (e.g. DuodermTM). The main advantage of this technique is? a Reduced risk of central line associated infections b Reduced risk of amniotic membrane rupture c Reduced time t…

A baby with a giant omphalocele is born at 33 weeks gestation with a birth weight of 1800 gm. They have respiratory distress requiring intubation and mechanical ventilation. What is the most likely cause of respiratory morbidity in this baby with giant omphalocele? a pneumonia and sepsis b pulmonary hypoplasia c hyaline membrane disease d meconium aspiration e associated congenital diaphragmatic hernia

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A female fetus is diagnosed with omphalocele on prenatal ultrasound. At 26 weeks gestation, omphalocele diameter / abdominal circumference = 0.24. No other fetal anomalies are detected. She is born by C-section at 39 weeks gestation. 24 hours after birth, she has 100% SaO2 while spontaneously breathing room air, is hemodynamically stable, has no other obvious anomalies on physical exam, and has a normal echocardiogram. The sac contains liver and intestine. How would you proceed?

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[size=20px]A 28-week gestation premature newborn has a giant omphalocele. The sac was torn during delivery and a ten cm loop of small intestine has herniated through the tear. Although otherwise stable, he requires mechanical ventilation. The best initial management of this complicated omphalocele is A excision of sac and primary fascial repair. B comfort care only. C excision of sac and split thickness skin graft. D suture repair of the sac and topical antibiotic. E excision of sac and bowel resection.​[/size]

A newborn boy with a prenatal diagnosis of omphalocele presents with this large structure at the umbilicus. The baby is asymptomatic and the remainder of the exam is normal. How will you approach this anomaly?​

A 36-week gestation, two kilogram infant is born with a very large omphalocele pictured below. The fascial defect measures approximately eight cm. The sac is intact but contains liver and multiple loops of bowel. The child has a loud heart murmur. Mechanical ventilation is required. [size=20px]The most appropriate initial management of this patient with an omphalocele is A attempted primary closure B component separation technique C placement of tissue expanders D non operative management E placement of silo around abdominal contents​[/size]

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[size=20px]You are asked to see a couple with a fetus that has a 30-week ultrasound that reveals an apparent omphalocele. In counseling the family, the finding most associated with a poor outcome in omphalocele is A maternal age. B polyhydramnios. C liver herniation. D small bowel dilation. E ratio of omphalocele to transverse abdomen diameter of 0.5.[/size]

please write the answer and your justification, correct answer will be submitted after 48 hrs A 36 week, 2.8 kg infant is born with a prenatally diagnosed small omphalocele. Both the karyotype and fetal echocardiogram were normal, and the infant is breathing comfortably on room air. [center][/center] [size=20px]The preferred management of this small omphalocele is A Umbilical cord dessication by air exposure B Ligation above Wharton’s jelly C Reduction of contents by cord twisting, with ligation at base of cord D Primary fascial closure[/size]

first one to post answer win Why all patients with omphalocele should undergo close blood-sugar monitoring for 48–72 hours after birth ?

[b]omphalocele decision making chart [/b]