Clinical Experiences of Omphalocele and Gastroschisis

Abstract

Thirty four cases with omphalocele and 20 cases with gastroschisis experienced at our hospitals during the period from 1970 to 1979 were reviewed. Overall mortality of omphalocele was 44.1% and there was no chronological improvement in the Survival rate. On the other hand, mortality of gastroschisis has significantly decreased recently. The mortality rate was 14.3% (one death in 7 cases) during last 3 years, while it was 53.8% (7 deaths per 13 cases) before 1976. Factors are contributing to the decrease of mortality in gastroschisis, (1) progress in general management of prematurity, (2) nutritional support using intravenous hyperalimentation and (3) respiratory care by mechanical ventilation in the first 24-48 hrs after operation. Twentry four cases (73.6%) of omphalocele were associated with other congenital anomalies, five of which were directly responsible for death. Abnormaly narrow thorax which was associated with respiratory distress were observed in 6 cases with giant omphalocele. Three of them died in a few days after admission. It seems that mortality of omphalocele may not decrease to same level as that of gastroschisis because of high incidence of severe associated anomalies.