2026 Volume 62 Issue 2 Pages 218-223
Cloacal exstrophy (CE), a rare congenital anomaly, presents with considerable variability in the size of the bladder plate and associated omphalocele. We report a case of CE with a liver-containing giant omphalocele, successfully treated by paint and wait management.
Case: A male infant was prenatally diagnosed as having CE by fetal MRI at 32 weeks and 4 days of gestation. He was born at 38 weeks and 6 days, weighing 2686 grams. Postnatal examination confirmed CE with a giant omphalocele. Epithelialization of the omphalocele was promoted using silver-containing antimicrobial wound dressings. Enteral nutrition was initiated, and weight gain was achieved. On day 58, after complete epithelialization of the omphalocele, a delayed surgical intervention was performed: the cecal plate was tubularized, and the blind end of the hindgut was brought out as an end stoma, and the abdominal cavity was covered with the skin and approximated bladder plates. Although this strategy may prolong hospitalization, it represents a safe and viable treatment option for CE cases with a giant omphalocele.
