Celio-mesenteric Trunk Associated with Giant Omphalocele: Surgical Consequences

We report the first case of a newborn presenting with a celio-mesenteric trunk variation associated with a giant omphalocele. The celio-mesenteric trunk was unexpected and unseen during the staged surgical closure. After partial reintegration of the liver, the newborn presented refractory hypovolemi...

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Autores principales: Laquievre,Antoine, Hitier,Martin, Petit,Thierry, Ravasse,Philippe, Rod,Julien
Lenguaje:English
Publicado: Sociedad Chilena de Anatomía 2017
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Acceso en línea:http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0717-95022017000300023
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Sumario:We report the first case of a newborn presenting with a celio-mesenteric trunk variation associated with a giant omphalocele. The celio-mesenteric trunk was unexpected and unseen during the staged surgical closure. After partial reintegration of the liver, the newborn presented refractory hypovolemia with anuria, leading to redo surgery. This procedure revealed ischemia of the liver and necrosis of the entire gastrointestinal tract except the colon. Despite treatment, including liver externalization, the infant did not survive. The autopsy revealed a celio-mesenteric trunk, a rare anomaly characterized by a common origin of the celiac axis and the superior mesenteric artery from the aorta. This association may explain the dramatic consequences of the staged closure procedure. Awareness of the association of celio-mesenteric trunk and omphalocele would allow the surgeon to take extra care during this delicate surgery.