Giant omphalocele in preterm newborns: case report (Colombia)

Abstract

Omphalocele is a congenital defect of the anterior abdominal wall that allows herniation of membrane-covered viscera. We present the case of a 32-week preterm male newborn with a prenatal diagnosis of giant omphalocele, who at birth presented progressive respiratory distress requiring invasive mechanical ventilation and surfactant, with good response and early extubation. The abdominal defect was initially managed with a negative pressure system, since primary closure was not possible. No major cardiac malformations were identified, except for meso-dextrocardia and mild left ventricular dysfunction. Management included hemodynamic stabilization, parenteral nutritional support and antibiotic prophylaxis. The patient evolved to be clinically stable, with no evidence of sepsis or hemodynamic complications, and was referred to a more complex center for definitive surgical resolution. This case aims at reinforcing the initial comprehensive management of neonates with giant omphalocele, which is key to favor the prognosis of a highly complex defect.