Use of mercurochrome in the management of the large exomphalos.

The topical application of solutions containing mercury has remained popular in the conservative management of the large exomphalos, despite recent reports of high organ mercury levels occurring in neonates who have died following this type of treatment. There are few reports of mercury poisoning being recognized in survivors. This report records blood and urine mercury levels in four patients with no apparent sequelae after treatment with Mercurochrome and provides guidelines for the safer use of mercurial solutions in the conservative management of exomphalos: one thin application of 1% Mercurochrome be applied to the intact sac; thereafter, Mercurochrome be applied sparingly only to areas that remain moist; blood and urine levels of mercury be monitored routinely; and applications ceased whenever mercury levels exceed the minimum toxic level. Only with this sparing and judicious use of mercurial solutions is the hazard to the infant kept to a minimum.