Management Of Abdominal Masses In The Newborn: Experience Of The Neonatology Department Of Sfax (Tunisia)

Background Abdominal masses in neonates reflect a wide spectrum of diseases, from lesions that can cause significant morbidity and mortality, to conditions readily corrected surgically, to entities which may be safely observed. Objective To evaluate epidemiology, clinical features, management and outcome of abdominal masses in the newborn. Methods It’s a retrospective study of all cases of abdominal masses registered in the neonatology department of Sfax between 2004 and 2019. Results Thirteen patients were included in the study. A female predominance was noted (sex ratio = 0.18) . Antenatal diagnosis was made in 10 cases. Seven patients were born via cesarean section. The mean gestational age was 37.7 weeks. Mean birth weight was 3160 g. Three patients had fetal acute suffering and respiratory distress. The most frequent physical finding was palpable abdominal mass (n=9) . Ultrasonography (n =13), abdominal scan (n=3) and MRI (n =4) were used for diagnosis. Tumor sizes ranged from 4.6 to 10 cm. We had identified renal cystic lymphangioma (n=1), Infantile myofibromatosis (n=1), ileal duplication (n=3), hydrocolpos (n=4) and ovrian cysts (n=4). Total resection was the treatment for ileal duplication ,ovarian cysts and lymphangioma cysts cases.The newborn with infantile myofibromatosis received medical treatment (vincristine) after incomplete resection. The treatment of hyrocolpos was based on simple hymenotomy in two cases and laparotomy in the other two complicated cases. Mean follow-up time was 24 months. Only one patient who had giant hydrocolpos died of refractory shock and acute kidney failure 3 days after surgery. Conclusions Most neonatal abdominal masses are due to benign lesions. Some of them may provide diagnostic difficulties. Most of masses require surgical treatment, which can be safely performed in small infants by trained personnel. However genuine controversy exists in the management of some lesions including infantile myofibromatosis.