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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Bibliographic Details
Published inInternational journal of morphology Vol. 35; no. 3; pp. 938 - 941
Main Authors Laquievre, Antoine, Hitier, Martin, Petit, Thierry, Ravasse, Philippe, Rod, Julien
Format Journal Article
LanguageEnglish
Portuguese
Published Sociedad Chilena de Anatomía 01.09.2017
Subjects
ANATOMY & MORPHOLOGY
Onfalocele gigante
Tronco celíaco-mesentérico
Isquemia mesentérica
Celio-mesenteric trunk
Mesenteric ischemia
Mesenteric arterial variation
Valproato sódico
Sodium valproate
Variación arterial mesentérica
Giant omphalocele
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Summary: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.
ISSN:0717-9502
0717-9502
DOI:10.4067/S0717-95022017000300023