CLINICAL CASE OF CONSERVATIVE TREATMENT OF A NEWBORN WITH LARGE OMPHALOCELE

The treatment of newborns with congenital malformations, despite the latest advances in surgery and neonatal intensive care, remains one of the most pressing problems in medical science. Among them is such a congenital malformation of the anterior abdominal wall as omphalocele. The aim: the aim of this work was to share the experience of conservative treatment for large omphalocele in a newborn. Materials and methods: The examination of the infant in the hospital included clinical monitoring of the patient over time, laboratory tests (general blood analysis, general urine analysis, biochemical blood tests), radiological examination (X-rays of the chest and abdominal organs, if necessary with contrast medium), ultrasound (ultrasound of the brain, heart, abdominal organs, kidneys, pleural cavities, and lungs), bacteriological tests (stool analysis for pathogenic flora), ultrasound of the brain, heart, abdominal organs, kidneys, pleural cavity and lungs), bacteriological tests (stool analysis for pathogenic flora, bacterial cultures from the eyes, nose, throat and umbilical stump) and genetic counseling. Results: Due to the large size of the omphalocele and the pronounced visceral-abdominal disproportion, surgical correction of this pathology was not feasible. A conservative treatment approach was implemented. According to the treatment protocols, the infant underwent a comprehensive evaluation. Major treatment steps included: maintenance on a resuscitation table with monitoring of vital signs, infusion therapy with partial parenteral nutrition, enteral feeding, antibiotic therapy, and surgical management of the hernia sac. The infant remained in the hospital for 83 bed days. As a result of treatment, the hernia sac was epithelialized and gastrointestinal function was restored. The infant was discharged home on enteral nutrition with positive weight gain. Conclusions: Conservative treatment is the method of choice for the management of large omphalocele with pronounced visceral-abdominal disproportion in the newborn. The success of conservative treatment of this pathology is impossible without adequate parenteral nutrition. Early initiation of enteral feeding and weight gain are favorable prognostic factors for the child's recovery.