In this very brief lecture, I’m going to
review gastroschisis and omphalocele.
These are the kinds of problems
that can show up on exam
and that you need
to know they exist.
But generally, exams won't
have too much there in about
what you have to know about them.
So I’ll try and review the important
information and make this brief.
So an omphalocele is a midline abdominal
wall defect as you can see here.
The viscera is still in the peritoneal sac.
This happens in roughly
1 in 5,000 babies.
So it’s rare, but most largest birthing
centers will see one or two a year.
There are associated anomalies
in half of these babies.
So we should call a
geneticist in many cases.
They may have cardiac anomalies,
renal anomalies, skeletal anomalies
or even neural tube defects like
anencephaly or spina bifida.
The prognosis varies depending
on really the other anomalies.
The intestinal material can be usually
surgically repaired without too much trouble.
This is compared to the gastroschisis.
A gastroschisis is a full thickness
defect in the abdominal wall.
The intestinal material is
hanging out of the abdomen.
There is an evisceration of bowel and in
this case, there is no covering membrane.
This is less common.
It happens in roughly one
in ten thousand births.
Maybe one birth a year in
large birthing center.
These patients have associated defects
in a smaller percent of the
time, about 10% of the time.
They may have intestinal
atresia or duplication.
They may have undescended testes.
These patients have an excellent
prognosis if it’s a small defect.
If it’s a large defect, these infants
can run into run some trouble.
Small defects are generally reduced and have
a primary closure, they just sew it up.
But large defects require a gradual
reduction over three to ten days.
These kids may have other symptoms
too such as respiratory distress
or need other things in the
neonatal intensive care unit.
So great care has
to be provided.
So that’s my quick summary of
gastroschisis and omphalocele.
Thanks for your attention.