Has the liver and other visceral organs migrated to its normal position in children with giant omphalocele? A follow-up study with ultrasonography.
This study evaluates whether, on the long run, in patients born with a giant omphalocele, the liver and other solid organs reach their normal position, shape, and size. Seventeen former patients with a giant omphalocele, treated between 1970 and 2004, were included. Physical examination was supplemented with ultrasonography for ventral hernia and precise description of the liver, spleen, and kidneys. The findings were compared with 17 controls matched for age, gender, and body mass index. We found an abnormal position of the liver, spleen, left kidney, and right kidney in eight, six, five, and four patients, respectively. An unprotected liver was present in all 17 patients and in 11 controls, the difference being statistically significant (p = 0.04). In ten of the 11 patients with an incisional hernia, the liver was located underneath the abdominal defect.


CONCLUSIONS
In all former patients with a giant omphalocele, an abnormal position of the liver and in the majority of them, an incisional hernia was also found. The liver and sometimes also the spleen and the kidneys do not migrate to their normal position. Exact documentation and good information are important for both the patient and their caretakers in order to avoid liver trauma.
Department of Surgery, Division of Paediatric Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. fcvaneijck@gmail.com
Floortje Clemens
FC
van Eijck
Willemijn M
WM
Klein
Carla
C
Boetes
Daniel C
DC
Aronson
Rene M H
RM
Wijnen
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006554:Hernia, Umbilical / Q000000981:diagnostic imaging*; D006555:Hernia, Ventral / Q000000981:diagnostic imaging; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging; D008099:Liver / Q000000981:diagnostic imaging*; D008297:Male; D013154:Spleen / Q000000981:diagnostic imaging; D014463:Ultrasonography; D014781:Viscera / Q000000981:diagnostic imaging*; D055815:Young Adult