ULTRASONIC DOPPLER MEASUREMENTS OF VISCERAL BLOOD-FLOW IN THE REPAIR OF GIANT OMPHALOCELE

An ultrasonic Doppler device was used for visceral perfusion monitorin g in the repair of a giant omphalocele. A full-term newborn, antenatal ly diagnosed as having middle celosomia involving the entire liver, st omach, spleen and small intestine, underwent a staged repair following the method of Gross after visceral compression induced by periodicall y squeezing a Dacron membrane silo. The hilum of the omphalocele was s emicircular and measured 70 mm in diameter; the membrane was kept inta ct. The blood non of the abdominal inferior vena cava (IVC), hepatic v ein (HV) and portal vein (PV) was serially examined. During the 11-day process of repair, the data consistently showed an IVC flow of over 6 0 ml/min, a PV flow of over 100 ml/min, and an IVC pressure of under 1 5 mmHg in this patient, whose birth weight was 3024 g. These values we re closely correlated with the clinical status and the ultrasonographi c findings' showing angulation and decompression of the IVC and HV by visceral contents. Ultrasonic Doppler blood now measurement provides a sensitive, noninvasive indicator of visceral organ viability during o mphalocele repair.