Management of an omphalocele with ileal perforation: A case report

Introduction: Omphalocele is a congenital midline abdominal defect characterized by the herniation of abdominal organs through the umbilical ring, enclosed within a membranous sac. It is associated with significant morbidity and rare complications such as bowel perforation, which pose unique management challenges. Presentation of the case: A male baby was delivered vaginally at 33 + 5 weeks of gestation to a healthy mother with unremarkable initial findings. At 13 h of life, the mother noticed discharge from the umbilical region, prompting referral to our center. Examination and investigations revealed an omphalocele with ileal perforation. The sac was then excised, ileal perforation repaired and the abdominal defect was closed. Postoperatively the neonate was managed in NICU. The baby was discharged on POD 8 in stable conditions. Discussion: Bowel perforation is a rare but life-threatening complication of omphalocele. Delayed diagnosis or improper handling, such as clamping over the sac, may lead to vascular compromise and even bowel perforation. Conclusion: Omphalocele-associated ileal perforation is a rare condition requiring immediate surgical management and postoperative care. Early intervention and meticulous monitoring are pivotal in ensuring survival and recovery.