Use of Components Separation Technique for Staged Abdominal Closure in a One-Year-Old Patient With Ruptured Giant Omphalocele

• Saito Takeshi

  Department of Pediatric Surgery (E6), Graduate School of Medicine, Chiba University

• Hishiki Tomoro

  Department of Pediatric Surgery (E6), Graduate School of Medicine, Chiba University

• Mitsunaga Tetsuya

  Department of Pediatric Surgery (E6), Graduate School of Medicine, Chiba University

• Nakata Mitsuyuki

  Department of Pediatric Surgery (E6), Graduate School of Medicine, Chiba University

• Terui Elena

  Department of Pediatric Surgery (E6), Graduate School of Medicine, Chiba University

• Komatsu Shugo

  Department of Pediatric Surgery (E6), Graduate School of Medicine, Chiba University

• Yokoyama Yukiko

  Department of Pediatric Surgery (E6), Graduate School of Medicine, Chiba University

• Kobayashi Masafumi

  Department of Pediatric Surgery (E6), Graduate School of Medicine, Chiba University

• Yoshida Hideo

  Department of Pediatric Surgery (E6), Graduate School of Medicine, Chiba University

Bibliographic Information

Other Title

• 腹壁閉鎖が困難な巨大臍帯ヘルニアに対するcomponents separation technique(CST)法
• 症例報告 腹壁閉鎖が困難な巨大臍帯ヘルニアに対するcomponents separation technique(CST)法
• ショウレイ ホウコク フクヘキ ヘイサ ガ コンナン ナ キョダイ セイタイ ヘルニア ニ タイスル components separation technique(CST)ホウ

Abstract

At birth, the patient suffered from a ruptured giant omphalocele with the liver, stomach, small intestine, and most parts of the large intestine protruding from a 4cm-sized hernia orifice. Soon after birth, the silastic sheet wall was constructed around the hernia defect to cover the contents and, after 15 days of embedding, the radical abdominal closure was performed but only in vain. After the residual umbilicus cord was used to cover the protruded hernia contents, conservative treatments were continued to facilitate her growth. When the epithelization of the cords was confirmed, the patient was readmitted to our institution for the closure of the giant ventral hernia at the age of 1 year and 8 months, weighing 9.5 kg. The CT showed the size of the hernia was 72×59 mm and the volume of the contents was 60 cm^3, equivalent to 6.3% of the entire abdominal volume. The CST technique includes 3 major parts: extending the subcutaneous abrasion widely, excising the aponeurosis a few cm lateral to the sheath along the semilunar line, and mobilizing bilateral rectus sheath to the midline. That created about 4 cm of mobilization for each sheath, allowing the loose approximation in the linea alba. The postoperative course was uneventful and she was discharged 13 days after the operation.

Journal

• Journal of the Japanese Society of Pediatric Surgeons

  Journal of the Japanese Society of Pediatric Surgeons 48 (2), 241-248, 2012

  The Japanese Society of Pediatric Surgeons

Keywords

• omphalocele
• abdominal closure
• external oblique muscle
• ventral hernia

Details

• CRID: 1390001204831515776
• NII Article ID: 110009437112
• NII Book ID: AN00192281
• DOI: 10.11164/jjsps.48.2_241
• ISSN: 21874247
• ISSN: 0288609X
• NDL BIB ID: 023682761
• Web Site: http://id.ndl.go.jp/bib/023682761
• Web Site: https://ndlsearch.ndl.go.jp/books/R000000004-I023682761
• Web Site: https://search.jamas.or.jp/link/ui/2012221374
• Text Lang: ja
• Data Source:
  • JaLC
  • NDL
  • CiNii Articles
  • KAKEN
• Abstract License Flag: Disallowed