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Abdominal Defect Flashcards

1
Q

Q: What are the two most common congenital abdominal wall defects?

A

A: Gastroschisis and omphalocele.

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2
Q

Q: At what gestational age does physiological midgut herniation occur?

A

A: 6th week.

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3
Q

Q: What is the incidence of gastroschisis?

A

A: 1 in 4000 live births.

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4
Q

Q: What is the typical location of the defect in gastroschisis?

A

A: To the right of the umbilicus.

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5
Q

Q: What is a common associated anomaly in gastroschisis?

A

A: Intestinal atresia.

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6
Q

Q: What is the survival rate for gastroschisis?

A

A: Excellent.

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7
Q

Q: What is the primary goal of surgical management in gastroschisis?

A

A: Return the bowel with minimal risk.

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8
Q

Q: What is the incidence of omphalocele?

A

A: 1 in 4000-6000 live births.

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9
Q

Q: What is the sac of an omphalocele covered by?

A

A: Amnion and peritoneum.

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10
Q

Q: What chromosomal abnormalities are commonly associated with omphalocele?

A

A: Trisomies 13

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11
Q

Q: What is a common cardiac abnormality associated with omphalocele?

A

A: Present in 45% of patients.

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12
Q

Q: What is the initial care for a newborn with omphalocele?

A

A: NG tube placement

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13
Q

Q: What is the non-operative management option for omphalocele?

A

A: Scarification treatment.

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14
Q

Q: What is the surgical management option for large omphaloceles?

A

A: Staged repair.

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15
Q

Q: What is a common complication after omphalocele closure?

A

A: Respiratory distress.

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16
Q

Q: What is the incidence of umbilical hernia in full-term neonates?

A

A: 20%.

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17
Q

Q: What is the typical spontaneous closure rate for umbilical hernias?

A

A: 80% by 4-5 years of age.

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18
Q

Q: What is the surgical indication for umbilical hernia?

A

A: No spontaneous closure by 5 years

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19
Q

Q: What is the embryological cause of gastroschisis?

A

A: Failure of the umbilical coelom to develop.

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20
Q

Q: What is the embryological cause of omphalocele?

A

A: Failure of the bowel to return to the body cavity.

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21
Q

Q: What is the risk factor for gastroschisis related to maternal age?

A

A: Young maternal age.

22
Q

Q: What is the risk factor for omphalocele related to maternal age?

A

A: Extremes of maternal age.

23
Q

Q: What is the prenatal diagnostic tool for gastroschisis?

A

A: 2nd trimester ultrasound.

24
Q

Q: What is the prenatal diagnostic tool for omphalocele?

A

A: 2nd trimester ultrasound.

25
Q: What is the typical size of the defect in gastroschisis?
A: 2-3 cm diameter.
26
Q: What is the typical size of the defect in omphalocele?
A: >4 cm.
27
Q: What is the common associated anomaly in omphalocele?
A: Cardiac abnormalities.
28
Q: What is the common associated anomaly in gastroschisis?
A: Intestinal atresia.
29
Q: What is the typical presentation of gastroschisis at birth?
A: Bowel loops freely floating in amniotic fluid.
30
Q: What is the typical presentation of omphalocele at birth?
A: Large defect with sac covered by amnion and peritoneum.
31
Q: What is the primary closure method for gastroschisis?
A: Primary reduction with operative closure.
32
Q: What is the staged closure method for gastroschisis?
A: Silo placement and serial reductions.
33
Q: What is the complication of gastroschisis related to bowel exposure?
A: Edematous and proteinaceous fluid transudation.
34
Q: What is the complication of omphalocele related to increased intra-abdominal pressure?
A: Respiratory distress.
35
Q: What is the long-term outcome for patients with large omphaloceles?
A: GERD
36
Q: What is the long-term outcome for patients with gastroschisis?
A: Generally good survival rate.
37
Q: What is the risk factor for gastroschisis related to maternal drug use?
A: Use of vasoconstrictive drugs.
38
Q: What is the risk factor for omphalocele related to maternal obesity?
A: Maternal obesity.
39
Q: What is the risk factor for gastroschisis related to environmental exposure?
A: High levels of nitrosamines.
40
Q: What is the risk factor for omphalocele related to vitamin use?
A: Failure to use multivitamins during pregnancy.
41
Q: What is the typical prenatal finding in gastroschisis?
A: Elevated alpha-fetoprotein (AFP).
42
Q: What is the typical prenatal finding in omphalocele?
A: Elevated maternal serum AFP.
43
Q: What is the typical postnatal care for gastroschisis?
A: Wrapping the bowel in warm saline-soaked gauze.
44
Q: What is the typical postnatal care for omphalocele?
A: NG tube placement and ventilator support.
45
Q: What is the typical surgical management for gastroschisis?
A: Silo placement and delayed closure.
46
Q: What is the typical surgical management for omphalocele?
A: Primary closure or staged repair.
47
Q: What is the typical complication of gastroschisis related to bowel atresia?
A: Intestinal atresia.
48
Q: What is the typical complication of omphalocele related to bowel infarction?
A: Bowel infarction.
49
Q: What is the typical complication of gastroschisis related to prolonged parenteral nutrition?
A: Cholestatic liver disease.
50
Q: What is the typical complication of omphalocele related to increased intra-abdominal pressure?
A: Renal failure.

Surgery (16 decks)

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