Surgical management of a massive omphalocele in a newborn: A case report study

Omphalocele is a rare congenital defect in the abdominal wall, affecting about 1 in 5000 to 10,000 newborns. It occurs when abdominal organs protrude through an opening at the base of the umbilical cord. Treating massive omphaloceles is highly challenging, requiring innovative and staged surgical methods to avoid complications like increased intra-abdominal pressure and potential organ damage. A female newborn with a 12.5 cm omphalocele was delivered emergently via cesarean section due to fetal distress. The exposed organs, including parts of the intestines and liver, were covered by a thin membrane. To minimize complications, a staged approach was opted for: first, a silo was placed to gradually reduce the herniated organs, followed by closure of the abdominal wall with absorbable sutures and biologic mesh. Omphalocele in newborns is a serious congenital defect where abdominal organs protrude through the umbilical cord, covered by a membrane. It requires urgent medical care to prevent complications like respiratory distress and infections. Treatment typically involves a team of pediatric surgeons and staged surgeries to repair the defect and ensure the infant's long-term health. The successful staged surgical method of silo reduction and biologic mesh for this massive omphalocele highlights the need for personalized surgical planning and multidisciplinary care. Six months later, the patient is thriving, showing no signs of recurrence or complications. •Omphalocele is a rare congenital defect occurring in about 1 in 5,000 to 10,000 live births.•The defect size (small, medium, large) affects the number of herniated organs and the complexity of surgery.•Surgical challenges, with large omphaloceles, may require staged repair and delayed closure to avoid complications.