Importance of the Early Management of Omphalocele Minor

Raashid Hamid, Gowhar Mufti, Sajad A Wani, Imran Ali, Bhat NA, Aejaz A Baba and Khursheed Sheikh

Background: This study was conducted to characterize the clinical features, associated anomalies, operative management, and operative findings in babies with omphalocele minor.
Material and Methods: This was a prospective study conducted over a period of 2 years, from 2011 to 2013. The clinical, radiological, and operative findings of all the babies diagnosed with omphalocele minor were recorded and
Results: A total of 12 patients of omphalocele minor were admitted to our department. Ten babies required
immediate exploration within first 5 days of life. The main indication of exploration was mechanical intestinal obstruction due to either associated atresia (five patients) or obstruction caused by mechanical compression of the gut by the small abdominal wall defect in remaining seven patients. Atretic segment was seen within the sac in two patients, distal ileal atresia in one, atresia at the neck of the abdominal wall defect in one, and ascending and transverse colonic atresia in one patient. Out of 10 patients in whom exploration was needed, 9 required resection anastomosis and in 1 patient intestine within the omphalocele sac had pregangrenous changes and did not require resection. There were three mortalities in our series; rest of the patients were doing well during the follow up.
Conclusion: Omphalocele minor although apparently seems to be a minor anomaly, but, as shown in our series,it has the potential of causing intestinal obstruction due to associated gut atresia or compression from tight abdominal defect. We conclude and recommend that all the patients with omphalocele minor should be admitted and observed for the possible development of intestinal obstruction and hence for early surgical intervention to prevent subsequent complications.