Anterior Abdomial Wall Defects Flashcards
Types of AAW Defects
• Bladder _______
•__________ anomaly
• ________ Exstrophy
• Ectopia ______
• ________
•___________
• Pentalogy of Cantrell
•_________ Syndrome
exstrophy
Body stalk
Cloacal; Cordis
Gastroschisis
Omphalocele
Prune belly
Omphalocele is a congenital _________ anterior abdominal wall ____________ defect of variable sizes in the area of the
_________ and covered by a _________, and containing herniated abdominal contents (typically ________ , but often ________, and occasionally ________ or ________).
central ; Musculo-aponeurotic fascia
umbilicus; membranous sac
bowel ; liver
stomach ; bladder
Gastroschisis is a congenital ______ anterior abdominal wall defect, usually to the (left or right?) side of the ________ characterized by evisceration of abdominal visceral especially ________ and without __________
complete
Right; umbilicus
bowel; any covering.
Embryology of abdominal wall
• _____th week-folding of the flat embryonic disk into ______ planes(________, ________, ________ and ________ folds)
• Each fold converge at the ________, thus obliterating the ________________.
• The lateral folds form the ________ of the abdominal wall
• The cephalic and caudal folds form the ________ and ________.
4-5th ; four
cephalic, caudal, right and left lateral
umbilicus ; extraembryonic coelom.
lateral ;epigastrum ; hypogastrum.
•
Embryology of abdominal wall
At ______ week-abdominal cavity becomes too small to accommodate its content
• Results in protrusion of the _____ into the _________________ at base of umbilical cord.
6th; midgut
residual extraembryonic coelom
Embryology of abdominal wall 2
• The temporary herniation involves ____ degrees __________ rotation of midgut around the __________ pedicle- Physiologic midgut herniation.
• There is further rotation to ____ degree in the abdominal cavity for reduction of
the hernia at ______ week.
90 ; counterclockwise
superior mesenteric pedicle
270 ; 12th week.
Rupture of omphalocele = ???
Gastroschisis
Risk Factors
• Gastroschisis
•________ maternal age
•______ gravida
• __________
• ________ secondary to IUGR
Young; Low
Prematurity; low birth weight
Risk Factors
Omphalocele
• ________ maternal age
•________ births
•______ gravida
• __________ births
• Maternal obesity(BMI >30kg/m2
• Maternal D.M
Increased
Multiple
High
Consecutive
Which has intact umbilical cord?
Gastroschisis or omphalocoele?
Gastroschisis
Classifications of Gastroschisis
•__________
•____________
Simple
complex
Classifications of Omphalocele
• _________ vs _________
• _________ sac vs _________ sac
• _________ vs _________
Minor vs Major
• Intact sac vs ruptured sac
• Syndromic vs non-syndromic
Definitive care
• Omphalocele
• In omphalocele minor- do __________
• In intact omphalocele major- do ________ Or _______ , use ________ agents.
• In ruptured omphalocele major- you may initially apply a ______, then close when __________________.
• In syndromic omphalocele- treat ______________
primary closure
staged or delayed repair; escharotic
silo; content is well reduced
associated abnormalities.
Definitive care of Gastroschisis
• If simple Gastroschisis- Apply ______ for ________ then do ____ closure
• If complex Gastroschisis- emergency ___________, repair _________ , atresia then either ________ as above, or ___________ and close primarily.
Silo; gradual reduction; primary
exploration; perforations; apply silo
resection of bowel
Omphalocele features
Hint:cOngenital
O-Umblicius ,old mother risk
M-(midline),membrane
PHA (Wharton jelly,parietal peritoneum ,amniotic membrane
Associated cOngenital defects
