USE OF DOPPLER ULTRASONOGRAPHY IN THE EVALUATION OF LIVER BLOOD-FLOW DURING SILO REDUCTION OF A GIANT OMPHALOCELE

Despite the utility of prosthetic silo reduction techniques, surgical treatment of giant omphaloceles containing herniated liver may result in acute compromise of hepatic vascular flow. The authors report a cas e of an infant with a giant omphalocele containing liver, in whom hepa tic vascular compromise was suspected during the course of prosthetic visceral reduction, Doppler ultrasonography performed on the herniated liver through the prosthetic silo demonstrated triphasic vascular flo w in the liver as well as normal hepatic venous flow and vena caval fl ow, and permitted continued gradual visceral reduction and a safe, del ayed primary abdominal wall closure on the seventh day of life. Dopple r ultrasonography performed through the silo may be an important diagn ostic adjunct during the visceral reduction phase of staged abdominal wall closure in infants with giant omphaloceles. Copyright (C) 1997 by W.B. Saunders Company.