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Omphalocele

more about Omphalocele


  • In this condition, intestine bulges out of the abdomen through the umbilical cord area.  Unlike an Umbilical Hernia (which is a loop of intestine safely covered by the outer layer of the umbilical cord), the omphalocele is only covered by a thin membrane of tissue.  This membrane is the normal peritoneum that covers the intestine inside the abdomen.  This means that the intestine is not protected from infection because there is no skin covering on it.
  • Small omphaloceles are small bulging loops of intestine, but large omphaloceles contain many large loops of intestine and may contain much of the liver as well.

  • An obvious protrusion of intestine into the umbilical cord area is seen, and the intestine is covered only with a very thin membrane (not the thick covering that lies over the normal umbilical cord).
  • There may be liver bulging into the umbilical cord, as well.
  • The abdomen appears small for the baby's size.

  • Unknown

  • The protruding intestine (or intestine and liver) bulging out of the body is an obvious birth defect, and this is diagnosed either during pregnancy or at delivery.
  • An ultrasound during pregnancy often detects this condition if the amount of protruding intestine and protruding liver is large.  If the physician can also be sure, from amniocentesis on the mother, that there is a chromosome abnormality as well, the parents can be sent for genetic counseling early in the pregnancy.  This way, the parents might know what other abnormalities to expect.

  • Chromosome abnormalities: trisomy 13, trisomy 18, and trisomy 21
  • In these abnormalities, 3 copies of a particular chromosome are present in the baby's tissues, instead of the normal 2 copies.
  • Congenital abnormalities of the heart, genital tract, or urinary tract
  • Beckwith's syndrome: a large tongue, large organs, too much insulin production, Low Blood Sugar, and an omphalocele

  • If the omphalocele is large and diagnosed by ultrasound during the pregnancy, the baby would likely be delivered by Caesarian section to avoid traumatizing the sac in the birth canal.
  • Immediately after birth, wet sterile dressings are applied to the omphalocele to prevent excessive dryness, and to prevent a torn peritoneum.  The dressings are a special salt and water mixture called saline.
  • Surgery is done as soon as possible to replace the organs into the abdomen.  Often, the organs will not fit into the small abdomen, so a sterile plastic covering ( or other sterile man-made material ) is used to build a housing for the organs until they slip back into the abdomen over a week or two.  The sterile plastic covering is sewn to the abdominal wall, completely covering the organs and the defect.
  • By gravity, the organs put the pressure of their weight onto the inside of the abdomen (the abdominal cavity).  The abdomen grows larger to accept the organs that did not fit initially,
  • Eventually, the intestines and liver slip back into the abdomen, and another surgical procedure closes the abdominal wall where the umbilicus is.

  • Rupture of the sac (peritoneum), with contamination of the intestines
  • Infection within the abdomen (peritonitis)

  • The protruding of the intestines and/or liver of the newborn is an emergency that needs immediate surgical treatment.

  • Umbilical Hernia is a bulging of intestine into the umbilical cord area.  It might be obvious in the newborn, or it might be obvious later on in the child's life.  The Umbilical Hernia is covered by the outer layer of the umbilical cord, or by skin of the navel, so it is not open to the outside air and not liable to infection from bacteria on the skin.
  • Gastroschisis is a bulging of intestine through a defect in the newborn's abdominal wall.  This bulge is located about an inch to the side of the umbilical cord, and not inside the umbilical cord area.  The bulging intestine is covered by a thin membrane, or jelly, and has no covering of skin.  Therefore, it is liable to get infected.




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