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Abdominal Wall Defects (Omphalocele and Gastroschisis)

By

William J. Cochran

, MD, Geisinger Clinic

Last full review/revision Apr 2021| Content last modified Apr 2021
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In abdominal wall defects, the muscles surrounding the abdominal cavity are weak or develop holes, allowing the intestines to spill out.

The two main abdominal wall defects are omphalocele and gastroschisis.

Omphalocele

An omphalocele is caused by an opening (defect) in the middle of the abdominal wall at the bellybutton (umbilicus). The skin, muscle, and fibrous tissue are missing. The intestines spill (herniate) out through the opening and are covered by a thin sac. The umbilical cord is in the center of the defect.

Gastroschisis

Gastroschisis also is an abnormal opening of the abdominal wall. In gastroschisis, the opening is near the bellybutton (usually to the right) but not directly over it, like in omphalocele. Like in omphalocele, the opening allows the intestines to spill out but unlike omphalocele, the intestines are not covered by a thin sac.

Before birth, because the intestines are not covered by a sac, they may be damaged by exposure to amniotic fluid, which causes inflammation. The inflammation irritates the intestine, which can result in complications such as problems with movements of the digestive system, scar tissue, and intestinal obstruction Intestinal Obstruction An obstruction of the intestine is a blockage that completely stops or seriously impairs the passage of food, fluid, digestive secretions, and gas through the intestines. The most common causes... read more .

Diagnosis of Abdominal Wall Defects

  • Blood tests

  • Usually prenatal ultrasonography

Treatment of Abdominal Wall Defects

  • Surgery

Once the infant is delivered, the exposed intestines are covered with a sterile dressing to keep them moist and protected and the infant is given fluids and antibiotics by vein. A long, thin tube is passed through the nose and placed in the stomach or intestine (nasogastric tube) to drain digestive fluid that collects in the stomach.

Surgery is required to replace the intestines in the abdomen and close the opening. If possible, surgery to repair the defect is done soon after birth. However, the skin of the abdominal wall often must be stretched for a few days before surgery so there is enough tissue to cover the opening. If the defect is large, doctors may need to create skin flaps to close it. If a large amount of intestine is sticking out, it is wrapped in a protective covering (called a silo) and gradually moved back into the abdomen over several days or weeks. When all the intestines are back in the abdomen, the opening is surgically closed.

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Preventive Health Care Visits in Infants
Frequent doctor visits are recommended for all infants younger than 1 year of age. These visits, also called well-child visits, make it possible to check development, look for health problems, provide age-appropriate vaccinations, and educate parents. Which of the following is a condition that might affect some infants born very prematurely, with less than 32 weeks of development in the uterus?
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