Neonatal giant exomphalos: A staged approach by external silo and DuoDERM dressing reductions followed by delayed primary repair

Abstract

We present a 2,440 g male neonate born by caesarian section at 38 weeks of gestational age. Baby had been diagnosed with giant exomphalos during prenatal scans. Due to the giant size of the exomphalos with liver being sac content to more than 50% and severe degree of abdominovisceral disproportion, the decision was made to adopt a staged-treatment approach. We created an external silo supplemented with DuoDERM compression dressings and adjusted it over three weekly sessions. The exomphalos was completely reduced, and the patient underwent delayed primary closure A modified single-layer abdominal wall repair was carried out uneventfully. The post-operative period was uncomplicated and at follow-up 4 years later the patient had no incisional hernia and is thriving well.