Experience with the Management of Exomphalos and Gastroschisis in Ibadan.

Abstract

Summary: Ninety-eight cases of exomphalos and gastroschisis were mana ged in the Department of Paediatrics, University College Hospital, Ibadan, over a period of eight years (1970-1978). Fifty-two (53%) of the cases were given non-operative while forty-six (47%) had surgical management. Mortality was 13% in those treated non-operatively and 59% in those treated surgically. The advantages and disadvantages of both forms of management are discussed and factors contribu ting to prognosis analysed. Operative management seems ideal when exomphalos occurs in an infant who is full term and of good weight, when the defect is minor and the sac is healthy, and when the scout films of the chest and abdomen reveal no significant abnormality, provided a good team of anaesthetists and surgeons is available for expedient surgical correction. For the fragile premature infant or any infant with major defect and infected defects, the use of non-operative technique under antibiotic cover as in-patients seems to offer the best course of action.