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Omphalocele

By

Jaime Belkind-Gerson

, MD, MSc, University of Colorado

Reviewed/Revised Aug 2023
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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 2 to 3 in 10,000 live births (1 References An omphalocele is a protrusion of abdominal viscera from a midline defect at the base of the umbilicus. (See also Overview of Congenital Gastrointestinal Anomalies.) In omphalocele, the herniated... read more References ). Infants with omphalocele have a very high incidence of other congenital anomalies (up to 70%), including

Omphalocele can be detected by routine prenatal ultrasonography (2 References An omphalocele is a protrusion of abdominal viscera from a midline defect at the base of the umbilicus. (See also Overview of Congenital Gastrointestinal Anomalies.) In omphalocele, the herniated... read more References ); 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.

References

  • 1. Nembhard WN, Bergman JEH, Politis MD, et al: A multi-country study of prevalence and early childhood mortality among children with omphalocele. Birth Defects Res 112(20):1787-1801, 2020. doi:10.1002/bdr2.1822

  • 2. Bence CM, Wagner AJ: Abdominal wall defects. Transl Pediatr 10(5):1461-1469, 2021. doi:10.21037/tp-20-94

Drugs Mentioned In This Article

Drug Name Select Trade
Principen
Garamycin, Genoptic, Genoptic SOP, Gentacidin, Gentafair, Gentak , Gentasol, Ocu-Mycin
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NOTE: This is the Professional Version. CONSUMERS: View Consumer Version
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