title: Use of Doppler ultrasonography in the evaluation of liver blood flow during silo reduction of a giant omphalocele.
abstract: Despite the utility of prosthetic silo reduction techniques, surgical treatment of giant omphaloceles containing herniated liver may result in acute compromise of hepatic vascular flow. The authors report a case of an infant with a giant omphalocele containing liver, in whom hepatic vascular compromise was suspected during the course of prosthetic visceral reduction. Doppler ultrasonography performed on the herniated liver through the prosthetic silo demonstrated triphasic vascular flow in the liver as well as normal hepatic venous flow and vena caval flow, and permitted continued gradual visceral reduction and a safe, delayed primary abdominal wall closure on the seventh day of life. Doppler ultrasonography performed through the silo may be an important diagnostic adjunct during the visceral reduction phase of staged abdominal wall closure in infants with giant omphaloceles.
authors.affiliation: Department of Surgery, Stanford University School of Medicine, CA, USA.
authors.forename: E D
authors.initials: ED
authors.lastname: Skarsgard
authors.forename: R A
authors.initials: RA
authors.lastname: Barth
mesh_terms: D006547:Hernia / Q000000981:diagnostic imaging / Q000209:etiology; D006554:Hernia, Umbilical / Q000000981:diagnostic imaging / Q000601:surgery*; D059685:Herniorrhaphy; D006801:Humans; D007231:Infant, Newborn; D007432:Intraoperative Period; D008099:Liver / Q000098:blood supply* / Q000000981:diagnostic imaging*; D008107:Liver Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D008297:Male; D012039:Regional Blood Flow; D012826:Silicone Elastomers / Q000627:therapeutic use*; D013526:Surgical Mesh; D018608:Ultrasonography, Doppler
chemical_list: D012826:Silicone Elastomers