Artificial abdominal hernia for the treatment of hepatomegaly in a neonatewith stage 4S neuroblastoma

Surgical widening of the abdomen by a silastic pouch as been used very rare ly in the management of critically ill infants with hepatomegaly due to neu roblastoma stage 4S. A female newborn baby was referred on the second day o f life because of local compressive effects of a massive hepatomegaly, whic h lead to multiorgan failure. An artificial abdominal hernia was created on the third day of life using a silastic pouch. During the operation oxygena tion and ventilation improved and urinary output returned. After chemothera peutic reduction of hepatic metastases and primary tumor the pouch was succ essfully removed on day 57 without local complications. The child has survi ved for more than 1 year and is in complete remission. An artificial abdomi nal hernia should be considered more often in the critically ill neonate wi th stage 4S neuroblastoma and massive hepatomegaly.