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INTESTINAL LACERATION SECONDARY TO CLAMPING OF AN OCCULT OMPHALOCELE

From the Department of Pediatrics at The Methodist Hospital and Downstate Medical Center of the State University of New York, Brooklyn, New York

Abstract

An omphalocele is a congenital defect of the abdominal wall, through which intestines and other intraabdominal organs protrude outside the abdominal cavity. The defect in the abdominal wall is covered by a translucent sac composed of peritoneum internally and amniotic membrane externally, through which the viscera can be seen. Such an anomaly is obvious and easily recognized at birth when the defect in the abdominal wall is large, but a small defect, also designated as umbilical cord hernia, is often unnoticed and may, when the cord is clamped, result in an iatrogenic laceration of the gut. We report such an encounter to alert the physician and suggest a method to prevent the iatrogenic misadventure. A careful follow-up of the child, TABLE I. COMPARATIVE STATUS OF THE PATIENT AND THE TWIN including developmental evaluation, is presented and compared with her healthy twin. A review of the relevant literature shows that the anomaly is not rare and that there is often a delay of several days in establishing the correct diagnosis, leading to a fatal outcome in some cases.