Taher Heba, Khalil Hajar, Ahmed Saad, Gad Mostafa, Elezaby Belal, Magdy Abdelazez, Abdullateef Khaled S
Pediatric Surgery, Cairo University, Egypt.
Cairo University, Egypt.
Int J Surg Case Rep. 2022 Jun;95:107175. doi: 10.1016/j.ijscr.2022.107175. Epub 2022 May 11.
Gastroschisis a common congenital anomaly in the anterior abdominal wall, the bowel is present outside the abdominal cavity, completely devoid of any coverings, management of gastroschisis involves umbilical cord graft coverage of the defect after bowel reduction when there are concerns about compartmental syndrome, this is a widely used technique but there are few reports about the incidence umbilical hernia development after this technique and need for future repair of the defect.
We had 8 patients with simple gastroschisis who had umbilical cord graft coverage of the defect at birth between 2017 and 2020, we present 4 patients who had the cord graft without cutting of rectus fascia, 2 patients resolved spontaneously and 2 developed an umbilical hernia requiring repair.
Umbilical cord graft has been reported in several studies, in those studies the authors reported the spontaneous closure of the defect and some reported that incising the rectus fascia will contribute to development of the umbilical hernia, in our series the rectus fascia was preserved yet 2 patients developed umbilical hernia.
Pediatric surgeons should look out for umbilical hernia in patients who had umbilical cord graft repair of gastroschisis defect and closure should be carried out by an experienced surgeon.
腹裂是前腹壁常见的先天性异常，肠管位于腹腔外，完全没有任何覆盖物。当担心出现间隔综合征时，腹裂的治疗包括在肠管还纳后用脐带移植物覆盖缺损，这是一种广泛应用的技术，但关于该技术后脐疝发生的发生率及缺损后续修复需求的报道较少。
我们有8例单纯腹裂患者，于2017年至2020年出生时接受了脐带移植物覆盖缺损治疗。我们展示4例未切开腹直肌筋膜进行脐带移植物治疗的患者，其中2例自发缓解，2例发生脐疝需要修复。
多项研究报道了脐带移植物的情况，在这些研究中，作者报告了缺损的自发闭合，一些研究表明切开腹直肌筋膜会导致脐疝的发生。在我们的系列研究中，保留了腹直肌筋膜，但仍有2例患者发生了脐疝。
小儿外科医生应留意接受脐带移植物修复腹裂缺损的患者是否发生脐疝，缺损闭合应由经验丰富的外科医生进行。
