Ectopia Cordis

Abstract

A case of ectopia cordis abdominalis occurred in our service at St. Vincent's Infant and Maternity Hospital recently. REPORT OF CASEHistory and Course.\p=m-\Themother, S. F., a primipara aged 23 years, entered the hospital Sept. 15, 1941, in active labor. She came under observation for prenatal care May 23, 1941, and the course of the pregnancy was normal. Her blood pressure and urine were normal on repeated examination, and her Kahn reaction was negative. Her pelvic measurements were adequate and the estimated date of delivery was October 24. At the onset of labor, a diagnosis of placenta praevia marginalis was made, and Drs. J. X. Bremner and A. C. Wise after manual cervical dilation made a midforceps delivery.In the mother's family history there was no known instance of congenital defect. The father had a niece with a congenital cardiac lesion. At birth, P. F., a girl weighed 5 pounds 12\m=1/2\ounces (2,522 Gm.) The first recorded axillary temperature was 97.6 F. There was considerable mucus, which had to be aspirated with a trachéal catheter before the infant could breathe. The cry was weak. There were no abnormalities except those associated with the heart and the anterior abdominal wall. A ventral hernia ( fig. 1), approximately 6 by 6 cm., extended from the xiphoid process to a point caudad to and including the umbilicus. Its lateral borders were the rectus abdominis muscles. The sternum was normally fused. The skin overlying the hernia was darker than the sur¬ rounding skin, was thin and stretched and contained small distended blood vessels. The lower border of the darkened skin included the umbilicus. Immediately adjacent to the umbilical cord the skin was ecchymotic. The hernial sac included in its upper portion, a visible and palpable pulsating firm mass identified as a ventricle, probably the left. Loops of compressible bowel were visible and palpable through the thin hernial wall in the lower portion. Heart sounds were heard loudest over the pulsating mass but could also be heard in the usual precordial area. No murmur was detected at this time.The infant was placed in a heated crib, and the pulsating hernial mass was covered only lightly with sterile gauze. On September 26, the eleventh day of life, the cord came off and at its site a flat 5 cm. crust was left which in ten days healed, leaving a smooth scar.

Combined pentalogy of cantrell with tetralogy of fallot, gallbladder agenesis, and polysplenia: a case report

“…Primary cardiac defects include ventricular septal defects (100%), atrial septal defect (53%), tetralogy of Fallot (20%), and ventricular diverticulum (20%). 1,27,36,46 Malrotation with dextroposition of the heart was reported twice. 28, 37 Despite the frequent association with anterior abdominal wall defects, involvement of abdominal organs is rarely described.…”

Ectopia Cordis in Man

“…Millhouse and Joos (1959) reviewed the literature concerning thoracic ectopia cordis and found 50 cases of this type. Blatt and Zeldes (1942) gave a detailed description of all reported cases up to 1938, since when no similar review has been attempted. We have therefore examined the literature from 1938 onwards and collected a further 48 cases which are listed in Table 11.…”

Case of Ectopia Cordis Surviving Nine Hours

“…

The condition of ectopia cordis was defined by Maude Abbott in 1915 (quoted by Blatt and Zeldes, 1942) as "a displacement so that the heart passes out of the thorax and comes to lie either upon the outer surface of the body or in the abdominal ctivity." In 1818 Weese (quoted by Blatt and Zeldes, 1942) classified cases into three types-" ectopia cordis cum sterni fissura, ectopia suprathoracica, and ectopia subthoracica "-and the first known example is that of Haller's in 1706.

…”

“…In 1818 Weese (quoted by Blatt and Zeldes, 1942) classified cases into three types-" ectopia cordis cum sterni fissura, ectopia suprathoracica, and ectopia subthoracica "-and the first known example is that of Haller's in 1706. In the most recent review of the literature Byron (1948) reports that of the 142 cases previously described 4 were suprathoracic or cervical, 81 were thoracic, 38 subthoracic or abdominal, 10 combined thoracoabdominal, and 9 unclassified.…”

“…In the most recent review of the literature Byron (1948) reports that of the 142 cases previously described 4 were suprathoracic or cervical, 81 were thoracic, 38 subthoracic or abdominal, 10 combined thoracoabdominal, and 9 unclassified. Blatt and Zeldes (1942), in an analysis of 53 cases, show that, of the three types of case, the cervical is incompatible with more than a few hours of life, and the abdominal has the greatest expectation of life (see Table). …”