Congenital Ventral Abdominal Wall Defects Flashcards
What is an omphalocele?
An omphalocele is a ventral, midline defect in the abdominal wall at the umbilical region that can contain both hollow and solid visceral organs. They are larger than 4 cm and are covered by peritoneal membrane internally and amniotic membrane externally.
What is an umbilical hernia?
Umbilical hernias are covered abdominal wall defects that are < 4 cm and contain only intestine (in contrast to omphalocele, which is > 4cm and can contain any intaabdominal organ).
List three congenital syndromes which are associated with omphalocele.
Thoracoabdominal syndrome (pentalogy of Cantrell), lower midline syndrome, and Beckwith-Wiedemann syndrome.
Which is more likely to have associated congenital anomalies, omphalocele or gastroschisis?
About 50-75% of neonates with an omphalocele have an associated congenital anomaly. Infants with gastroschisis are much less likely to have associated anomalies.
Compare the location of omphalocele with the location of gastroschisis.
Omphalocele is a midline defect, whereas gastroschisis is a lateral defect which is almost always to the right of the umbilicus.
How is omphalocele managed?
Immediate management includes covering the exposed omphalocele with plastic wrap and warm, saline-soaked gauze. IV antibiotics are started and antiseptic agents should be applied to the omphalocele membrane. Most infants then undergo staged repair.
What is gastroschisis?
A 2-5 cm lateral abdominal wall defect with exposed loops of small and large intestines that are short and thick due to an inflammatory reaction of the serosa.
What complication often occurs in conjunction with gastroschisis?
Midgut volvulus
What is the recommended management of gastroschisis?
Cover the intestines with warm, saline-soaked gauze and wrap with plastic wrap. These infants require primary surgical closure of the abdominal wall defect.
