PMC8131127_01
Day of life 1: Inferior aspect with bladder plates and intussuscepted ileum at cecal plate and large omphalocele.
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On physical examination, she had a giant liver containing omphalocele that was not amenable to the typical surgical strategy of early closure and conversion to bladder exstrophy ( Figs. 1 and 2 ).
Day of life 1: Large liver containing omphalocele.
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On physical examination, she had a giant liver containing omphalocele that was not amenable to the typical surgical strategy of early closure and conversion to bladder exstrophy ( Figs. 1 and 2 ).
Three months old: Postrepair with bowel patch between bladder plates and alloderm closure of omphalocele. Ostomy is in the left upper quadrant, under the gauze.
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Closure of the omphalocele sac was performed with an alloderm patch with pledgeted U-sutures as the liver became swollen during the surgery, and primary closure was not possible due to concern for increased tension and risk of compartment syndrome ( Fig. 3 ).
PMC8131127_02
Twelve months old: After alloderm patch has re-epithelialized. Bladder plates and bowel on inferior aspect of omphalocele.
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As of 12 months old, her omphalocele and bladder exstrophy closure had still not occurred due to the relative size of omphalocele ( Fig. 4 ).