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A D V E R T I S E M E N T
A D V E R T I S E M E N T
If the bowel can not be safely returned to the abdomen (due to risk of bowel infarction and/or respiratory compromise), placing a silo is an option. One mm reinforced silastic sheet is sewed with Prolene to the skin or fascia to create a tube around the viscera. The silo is created in the shape of a column and not a cone.
A D V E R T I S E M E N T
The bowel is gradually reduced into the abdomen daily. The silo can be sequentially tied , stapled, clamped or sutured. Betadine ointment is used liberally on the silo to decrease the risk of infection. The viscera should be reduced within one week. The child is then returned to the operating room and the abdomen closed.
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A D V E R T I S E M E N T
With primary closure of the abdomen, a purse string suture around the defect recreates an umbilicus. A central line is placed for total parenteral nutrition (TPN) as the bowel will frequently remain non-functional for weeks.
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This page was last modified on 4/4/1999.
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