Merck Manual

Please confirm that you are a health care professional

Loading

Omphalocele

By

William J. Cochran

, MD, Geisinger Clinic

Last full review/revision Aug 2019| Content last modified Aug 2019
Click here for Patient Education
NOTE: This is the Professional Version. CONSUMERS: Click here for the Consumer Version
Topic Resources

An omphalocele is a protrusion of abdominal viscera from a midline defect at the base of the umbilicus.

In omphalocele, the herniated viscera are covered by a thin membrane and may be small (only a few loops of intestine) or may contain most of the abdominal viscera (intestine, stomach, liver). Immediate dangers are drying of the viscera, hypothermia and dehydration due to evaporation of water from the exposed viscera, and infection of the peritoneal surfaces. The estimated incidence is 1 in 3000 to 5000 live births. Infants with omphalocele have a very high incidence of other congenital anomalies (up to 70%), including

Omphalocele can be detected by routine prenatal ultrasonography; if the disorder is present, delivery should be at a tertiary care center with personnel experienced in dealing with this disorder and the other associated congenital anomalies.

At delivery, the exposed viscera should be immediately covered with a sterile, moist, nonadherent dressing (eg, medicated petrolatum gauze that can then be covered with plastic wrap) to maintain sterility and prevent evaporation. The infant should then be given IV fluids and broad-spectrum antibiotics (eg, ampicillin, gentamicin), and a nasogastric tube should be placed. The amount of fluids needed is typically significantly higher than that needed for a normal healthy neonate (1.5 to 2 times) because of excessive fluid loss from the exposed gut.

The infant is evaluated for associated anomalies before surgical repair of the omphalocele. Primary closure is done when feasible. With a large omphalocele, the abdominal cavity may be too small to accommodate the viscera. In this case, the viscera are covered by a pouch or silo of polymeric silicone sheeting, which is progressively reduced in size over several days as the abdominal capacity slowly increases, until all of the viscera are enclosed within the abdominal cavity.

Drugs Mentioned In This Article

Drug Name Select Trade
GENOPTIC
No US brand name
Click here for Patient Education
NOTE: This is the Professional Version. CONSUMERS: Click here for the Consumer Version
Professionals also read

Also of Interest

Videos

View All
Overview of Ventricular Septal Defect
Video
Overview of Ventricular Septal Defect
3D Models
View All
Cystic Fibrosis: Defective Chloride Transport
3D Model
Cystic Fibrosis: Defective Chloride Transport

SOCIAL MEDIA

TOP