Early primary repair of giant omphalocele with favorable neonatal outcome

Abstract

Background: Omphalocele is a congenital midline abdominal wall defect characterized by herniation of abdominal contents (liver and bowel) into a membranous sac. We report a term female neonate with antenatally diagnosed large omphalocele with liver as content. Prenatal evaluation including karyotyping and whole exome sequencing was normal. A high-risk neonatal team attended delivery, and the sac was immediately protected to minimize fluid and heat loss. A temporary silo was placed to facilitate gradual reduction by gravity. The infant underwent elective primary repair on day 2 of life, with successful reduction of contents and closure of a 6 × 6 cm defect. The postoperative course was uneventful with early extubation, successful advancement to full feeds. The infant was discharged in stable condition after an 8-day NICU stay.