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Toddler thrives after rare abdominal defect treated with Botox

A toddler born with a rare abdominal defect is making progress after undergoing a groundbreaking treatment involving Botox.

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A toddler in central Iowa is defying the odds after a rare and life-threatening diagnosis, thanks to a doctor at MercyOne Des Moines.Hendrix Ayala is now an energetic, almost-2-year-old who loves mac and cheese, hot dogs and cars. But during his mom’s pregnancy, his future was uncertain.”They did state termination at 20 weeks. And I was like, I cannot do that,” Riley Ayala said.Hendrix was diagnosed in the second trimester with a giant omphalocele, a condition in which the abdomen does not fully develop in the womb. As a result, his stomach, intestines, spleen and liver were left outside of his body without protection.”I didn’t want to talk about it. I didn’t want to think it was real,” Riley said.Doctors say complications increase when the defect exceeds five centimeters. In Hendrix’s case, it measured closer to 10 centimeters.For the first year and a half of his life, Hendrix lived with a protrusion larger than a grapefruit.That changed when Dr. Ulises Garza Serna learned of a newer technique to treat the defect involving Botox. Garza believes this is the first time the method has been used in Iowa. After two surgeries, Hendrix is making steady progress.”He’s achieving some milestones that we did not have before,” Garza said.Though Hendrix’s mobility is delayed, and he’s only 20 pounds, his status is improving — now learning to walk with the help of physical therapy. His mom and dad are now focused on him retaining weight and preparing for future surgeries. “He is thriving. He’s growing slowly but surely,” Riley said.

A toddler in central Iowa is defying the odds after a rare and life-threatening diagnosis, thanks to a doctor at MercyOne Des Moines.

Hendrix Ayala is now an energetic, almost-2-year-old who loves mac and cheese, hot dogs and cars. But during his mom’s pregnancy, his future was uncertain.

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“They did state termination at 20 weeks. And I was like, I cannot do that,” Riley Ayala said.

Hendrix was diagnosed in the second trimester with a giant omphalocele, a condition in which the abdomen does not fully develop in the womb. As a result, his stomach, intestines, spleen and liver were left outside of his body without protection.

“I didn’t want to talk about it. I didn’t want to think it was real,” Riley said.

Doctors say complications increase when the defect exceeds five centimeters. In Hendrix’s case, it measured closer to 10 centimeters.

For the first year and a half of his life, Hendrix lived with a protrusion larger than a grapefruit.

That changed when Dr. Ulises Garza Serna learned of a newer technique to treat the defect involving Botox. Garza believes this is the first time the method has been used in Iowa.

After two surgeries, Hendrix is making steady progress.

“He’s achieving some milestones that we did not have before,” Garza said.

Though Hendrix’s mobility is delayed, and he’s only 20 pounds, his status is improving — now learning to walk with the help of physical therapy. His mom and dad are now focused on him retaining weight and preparing for future surgeries.

“He is thriving. He’s growing slowly but surely,” Riley said.

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Omaha, US
3:06 pm, May 15, 2026
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