Abdominal Defect Flashcards
Q: What are the two most common congenital abdominal wall defects?
A: Gastroschisis and omphalocele.
Q: At what gestational age does physiological midgut herniation occur?
A: 6th week.
Q: What is the incidence of gastroschisis?
A: 1 in 4000 live births.
Q: What is the typical location of the defect in gastroschisis?
A: To the right of the umbilicus.
Q: What is a common associated anomaly in gastroschisis?
A: Intestinal atresia.
Q: What is the survival rate for gastroschisis?
A: Excellent.
Q: What is the primary goal of surgical management in gastroschisis?
A: Return the bowel with minimal risk.
Q: What is the incidence of omphalocele?
A: 1 in 4000-6000 live births.
Q: What is the sac of an omphalocele covered by?
A: Amnion and peritoneum.
Q: What chromosomal abnormalities are commonly associated with omphalocele?
A: Trisomies 13
Q: What is a common cardiac abnormality associated with omphalocele?
A: Present in 45% of patients.
Q: What is the initial care for a newborn with omphalocele?
A: NG tube placement
Q: What is the non-operative management option for omphalocele?
A: Scarification treatment.
Q: What is the surgical management option for large omphaloceles?
A: Staged repair.
Q: What is a common complication after omphalocele closure?
A: Respiratory distress.
Q: What is the incidence of umbilical hernia in full-term neonates?
A: 20%.
Q: What is the typical spontaneous closure rate for umbilical hernias?
A: 80% by 4-5 years of age.
Q: What is the surgical indication for umbilical hernia?
A: No spontaneous closure by 5 years
Q: What is the embryological cause of gastroschisis?
A: Failure of the umbilical coelom to develop.
Q: What is the embryological cause of omphalocele?
A: Failure of the bowel to return to the body cavity.
Q: What is the risk factor for gastroschisis related to maternal age?
A: Young maternal age.
Q: What is the risk factor for omphalocele related to maternal age?
A: Extremes of maternal age.
Q: What is the prenatal diagnostic tool for gastroschisis?
A: 2nd trimester ultrasound.
Q: What is the prenatal diagnostic tool for omphalocele?
A: 2nd trimester ultrasound.
Q: What is the typical size of the defect in gastroschisis?
A: 2-3 cm diameter.
Q: What is the typical size of the defect in omphalocele?
A: >4 cm.
Q: What is the common associated anomaly in omphalocele?
A: Cardiac abnormalities.
Q: What is the common associated anomaly in gastroschisis?
A: Intestinal atresia.
Q: What is the typical presentation of gastroschisis at birth?
A: Bowel loops freely floating in amniotic fluid.
Q: What is the typical presentation of omphalocele at birth?
A: Large defect with sac covered by amnion and peritoneum.
Q: What is the primary closure method for gastroschisis?
A: Primary reduction with operative closure.
Q: What is the staged closure method for gastroschisis?
A: Silo placement and serial reductions.
Q: What is the complication of gastroschisis related to bowel exposure?
A: Edematous and proteinaceous fluid transudation.
Q: What is the complication of omphalocele related to increased intra-abdominal pressure?
A: Respiratory distress.
Q: What is the long-term outcome for patients with large omphaloceles?
A: GERD
Q: What is the long-term outcome for patients with gastroschisis?
A: Generally good survival rate.
Q: What is the risk factor for gastroschisis related to maternal drug use?
A: Use of vasoconstrictive drugs.
Q: What is the risk factor for omphalocele related to maternal obesity?
A: Maternal obesity.
Q: What is the risk factor for gastroschisis related to environmental exposure?
A: High levels of nitrosamines.
Q: What is the risk factor for omphalocele related to vitamin use?
A: Failure to use multivitamins during pregnancy.
Q: What is the typical prenatal finding in gastroschisis?
A: Elevated alpha-fetoprotein (AFP).
Q: What is the typical prenatal finding in omphalocele?
A: Elevated maternal serum AFP.
Q: What is the typical postnatal care for gastroschisis?
A: Wrapping the bowel in warm saline-soaked gauze.
Q: What is the typical postnatal care for omphalocele?
A: NG tube placement and ventilator support.
Q: What is the typical surgical management for gastroschisis?
A: Silo placement and delayed closure.
Q: What is the typical surgical management for omphalocele?
A: Primary closure or staged repair.
Q: What is the typical complication of gastroschisis related to bowel atresia?
A: Intestinal atresia.
Q: What is the typical complication of omphalocele related to bowel infarction?
A: Bowel infarction.
Q: What is the typical complication of gastroschisis related to prolonged parenteral nutrition?
A: Cholestatic liver disease.
Q: What is the typical complication of omphalocele related to increased intra-abdominal pressure?
A: Renal failure.
