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J Pediatr Surg. 2015 Sep;50(9):1477-80. doi: 10.1016/j.jpedsurg.2015.02.051. Epub 2015 Feb 23.

Systemic hypertension in giant omphalocele: An underappreciated association.

Author information

1
The Division of Pediatric General, Thoracic, and Fetal Surgery at the Children's Hospital of Philadelphia, and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA. Electronic address: peranteauw@email.chop.edu.
2
The Division of Pediatric General, Thoracic, and Fetal Surgery at the Children's Hospital of Philadelphia, and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.

Abstract

PURPOSE:

To evaluate the incidence, severity and duration of systemic hypertension in infants born with giant omphalocele (GO).

METHODS:

A retrospective review of patients born from 2003 through 2013 with a GO or intestinal atresia (control population) and managed at a single institution was performed. The hospital course was reviewed including all blood pressures, method of omphalocele repair, requirement for antihypertensive medications and renal function.

RESULTS:

Forty-five GO and 20 control patients met criteria for the study. Thirty-three GO patients underwent Schuster repair and 12 GO patients underwent delayed repair after epithelialization. Overall, 78% of GO patients had episodes of hypertension (82% Schuster and 67% delayed repair) compared to 15% of control patients (P<0.001). The majority of episodes were transient and occurred in the postoperative period (97%). Hypertension was persistent in 4 GO patients. These patients required antihypertensive medication at discharge, which was discontinued as an outpatient. No patient demonstrated significant evidence of renal abnormalities as indicated by renal ultrasound, urinalysis and/or serum creatinine level at the time of hypertension.

CONCLUSION:

Episodes of systemic hypertension are frequent in patients with GO. Episodes are often post-operative, transient and can be present in patients undergoing either a delayed or Schuster repair. A small subset of patients will have persistent hypertension requiring antihypertensive medication that can be weaned off in an outpatient setting.

KEYWORDS:

Abdominal wall defect; Congenital; Giant omphalocele; Schuster; Systemic hypertension

PMID:
25783355
DOI:
10.1016/j.jpedsurg.2015.02.051
[Indexed for MEDLINE]

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