Omphalocele and Hernia of Umbilical Cord: An Early Outcome Analysis from a Tertiary Care Hospital

Background: Omphalocele and hernia of umbilical cord (HUC) are frequent types of abdominal wall defect dealt by paediatric surgeon. We aimed to study the early outcome analysis of omphalocele and HUC in our tertiary care hospital. Material and Methods: A prospective observational study was carried out in our tertiary care teaching institute from 16 October 2018 to 15 April 2020. A detailed history, clinical examination, baseline blood investigations and radiological evaluation were performed in each case. Cases of omphalocele major were subjected to initial conservative management while all neonates with omphalocele minor and hernia of umbilical cord were managed surgically. Results Sixty-nine neonates with omphalocele major (17), minor (29) and HUC (23) were included in the study. Male to female ratio was 2.83: 1 in both omphalocele and HUC. Out of 17 patients of omphalocele major, 10 (58.82 %) were managed conservatively. Emergency surgery was performed in 4 patients (23.52%) while 3 patients (17.64%) died before any intervention. All patients of omphalocele minor and HUC were operated immediately except 1 patient (3.44%) of omphalocele minor who died before surgery. Mortality was 4 (23.52%), 8 (27.58%) and 4 (17.39 %) in omphalocele major, omphalocele minor and HUC respectively. Conclusion: There was male predominance in both of these defects. Early admission and timely management improve the prognosis. Primary anatomical repair is best in omphalocele minor and hernia of umbilical cord. In omphalocele major, primary anatomical repair is often not feasible, so “escharotic therapy” is a good alternative. We found that primary anatomical repair is better choice for omphalocele minor and conservative scar therapy is good for omphalocele major, until unless sac was ruptured.