By F/M/2do

77.52.48
Chief Complain: abdominal organ at the outside
It had been suffered by the patient since born about
3 days before admitted to Adam Malik Hospital. It
was through out from the umbilical and there was a
membrane that covered the organ from outter
environment. Initially patient with history of
delivered sectio caesaria (SC) by Obstetrician
because of previous SC, patient directly cries, which
birth weight 3200 gr, birth length 43 cm, history of
cyanotic (-). The mother had a regular ANC. History
of using medical and traditional herbs drug (-),
history of radiation exposure (-). Meconium (+) in
first 24 hours, there was no history of congenital
disease in family.
Present State:
• Awareness : Alert
• Heart Rate : 120x/mnt
• Respiratory Rate : 22 x/mnt
• Temperature : 37,00 C
• Body weight : 3200gr
General State

• Head : normochepali
– Mata : anemic conjunctive (-/-), icteric sclera(-/-),
– Throat and essophageal : no abnormalities
• Neck : Lymphadenopaty (-)
• Vertebra : no abnormalities
• Chest : no abnormalities
• Abdomen : in localized state
• Genitalia : male, no abnormalities
• Anal : no abnormalities
• Extremity : deformity (-), no abnormalities
Localized state :

Abdomen
I : seen abdominal organ
outside, streak out
from umbilical, viable
content, defect size ᴓ 7
cm, membrane (+) intact
P : soeple, defans (-)
P : thympany
A : peristaltic (+) N,
borborygmi (-)
Laboratory Finding :
– Hb / HT / WBC / PLT: 13,8 / 39 / 8.630 / 404.000
– Na / K / Cl : 134 / 3,9 / 105
– Gluc adr : 119
Working Diagnose
Omphalocele
Treatment at the ER:
• O2 nasal 1 l/m
• Temporary nil per mouth
• Insertion of OGT came out yelowish liquid 15 cc
• Insertion of catheter with OGT 3.5 Fr  initial 4 cc, UOP
2cc/hour
• IVFD D5%:NS 0,225% 15 microdrips/min
• Inj. antibiotic
• Covered the omphalocele with soft stocks
• Sim’s position
• Plan: defect closure elective