eMedicine Specialties > Pediatrics: Cardiac Disease and Critical Care Medicine > Neonatology
Omphalocele and Gastroschisis: Multimedia
Updated: Jul 22, 2009
Multimedia
 | Media file 1: Baby with an intact omphalocele. |
 | Media file 2: Baby with an umbilical cord hernia. |
 | Media file 3: Baby with gastroschisis. |
 | Media file 4: Baby with a ruptured omphalocele. |
 | Media file 5: Baby with gastroschisis and associated intestinal atresia. |
 | Media file 6: Baby with gastroschisis and colon atresia. Bulbous proximal end of the atretic colon is excised, and a colostomy is created at the abdominal wall defect. An anastomosis of the proximal, dilated colon to the distal microcolon (in view of its small caliber) would not function properly. The colostomy can be closed 4-6 weeks later. (Gastrostomy tubes are no longer routinely used.) |
 | Media file 7: Note the enlarged tongue in this baby with Beckwith-Wiedemann syndrome. |
 | Media file 8: Baby with pentalogy of Cantrell. |
 | Media file 9: Silo closure of a baby with gastroschisis. |
 | Media file 10: Completed reduction of the bowel contained within the silo; the silo is about to be removed and the abdominal wall closed. |
 | Media file 11: Baby with a giant omphalocele. |
 | Media file 12: Same patient as in Media file 11. Closure of the giant omphalocele using a synthetic patch. |
 | Media file 13: Same patient as in Media files 11-12. Tightening the abdominal wall closure |
 | Media file 14: Same patient as in Media files 11-13. Flank flaps were used to close the giant omphalocele in the baby whose patch became infected. |
 | Media file 15: Same patient as in Media files 11-14. The flank wounds were skin grafted and closure of the giant omphalocele obtained. |
 | Media file 16: Baby with prune-belly syndrome. |
 | Media file 17: Note the laxity of the abdominal wall in this baby with prune-belly syndrome. |
 | Media file 18: Baby with cloacal exstrophy. |
 | Media file 19: Note the bifid genitalia in this baby with cloacal exstrophy. |
 | Media file 20: In the repair of cloacal exstrophy, the ileum in the middle of the bifid bladder is excised and used to create an ostomy, and the bladder halves are approximated. |
 | Media file 21: Closure of the bladder exstrophy. |
 | Media file 22: Baby with bladder exstrophy and epispadias; note the appearance of the bladder mucosa, indicating chronic inflammation. |
 | Media file 23: Another view demonstrating the epispadias shown in Media file 23. |
 | Media file 24: Baby with isolated epispadias. |
 | Media file 25: An operative photo from the repair of a draining umbilicus. |
 | Media file 26: Closure of a giant omphalocele with an AlloDerm patch. |
 | Media file 27: Two months after implantation: epithelialization of the AlloDerm patch |
 | Media file 28: Eight months after implantation: epithelization is nearly complete, but a huge ventral hernia has developed. |
 | Media file 29: Persistent drainage from the umbilicus. |
 | Media file 30: Baby with an omphalocele. |
More on Omphalocele and Gastroschisis |
| Overview: Omphalocele and Gastroschisis |
| Differential Diagnoses & Workup: Omphalocele and Gastroschisis |
| Treatment & Medication: Omphalocele and Gastroschisis |
| Follow-up: Omphalocele and Gastroschisis |
 Multimedia: Omphalocele and Gastroschisis |
| References |
| Further Reading |
| « Previous Page |
References
Vermeij-Keers C, Hartwig NG, van der Werff JF. Embryonic development of the ventral body wall and its congenital malformations. Semin Pediatr Surg. May 1996;5(2):82-9. [Medline].
Suita S, Nagasaki A. Urachal remnants. Semin Pediatr Surg. May 1996;5(2):107-15. [Medline].
Moore TC. Omphalomesenteric duct malformations. Semin Pediatr Surg. May 1996;5(2):116-23. [Medline].
Duffy PG. Bladder exstrophy. Semin Pediatr Surg. May 1996;5(2):129-32. [Medline].
Wheatley JM, Stephens FD, Hutson JM. Prune-belly syndrome: ongoing controversies regarding pathogenesis and management. Semin Pediatr Surg. May 1996;5(2):95-106. [Medline].
Molenaar JC. Cloacal exstrophy. Semin Pediatr Surg. May 1996;5(2):133-5. [Medline].
Langer JC. Gastroschisis and omphalocele. Semin Pediatr Surg. May 1996;5(2):124-8. [Medline].
Suita S, Okamatsu T, Yamamoto T, et al. Changing Profile of Abdominal Wall Defects in Japan: Results of a National Survey. J Pediatr Surg. 2000;35:66-72. [Medline].
Tan KH, Kilby MD, Whittle MJ, et al. Congenital anterior abdominal wall defects in England and Wales 1987- 93: retrospective analysis of OPCS data. BMJ. Oct 12 1996;313(7062):903-6. [Medline].
Srivastava V, Mandhan P, Pringle K, Morreau P, Beasley S, Samarakkody U. Rising incidence of gastroschisis and exomphalos in New Zealand. J Pediatr Surg. March 2009;44(3):551-555. [Medline].
Puligandla PS, Janvier A, Flageole H, et al. Routine cesarean delivery does not improve the outcome of infants with gastroschisis. J Pediatr Surg. May 2004;39(5):742-5. [Medline].
Logghe HL, Mason GC, Thornton JG, Stringer MD. A randomized controlled trial of elective preterm delivery of fetuses with gastroschisis. J Pediatr Surg. Nov 2005;40(11):1726-31. [Medline].
McGuigan RM, Azarow KS. Is splanchnic perfusion pressure more predictive of outcome than intragastric pressure in neonates with gastroschisis?. Am J Surg. May 2004;187(5):609-11. [Medline].
Midrio P, Stefanutti G, Mussap M, D'Antona D, Zolpi E, Gamba P. Amnioexchange for fetuses with gastroschisis: is it effective?. J Pediatr Surg. May 2007;42(5):777-82. [Medline].
Olguner M, Hakguder G, Ates O, Caglar M, Ozer E, Akgur FM. Urinary trypsin inhibitor present in fetal urine prevents intraamniotic meconium-induced intestinal damage in gastroschisis. J Pediatr Surg. Aug 2006;41(8):1407-12. [Medline].
Dinatti LA, Meagher DP Jr, Martinez-Frontanilla LA. "Bucket handle" avulsion of intestine in gastroschisis. J Pediatr Surg. 28(6):840. [Medline].
Wada M, Kato T, Hayashi Y, et al. Intestinal transplantation for short bowel syndrome secondary to gastroschisis. J Pediatr Surg. Nov 2006;41(11):1841-5. [Medline].
Moon S , Jung S , Park K. Ruptured fetal omphalocele complicated by midgut volvulus with strangulation. January 2009;44:1:303-304. [Medline].
[Guideline] Finnish Medical Society Duodecim. Ultrasound scanning during pregnancy. EBM Guidelines. Feb 15 2008.
Pacilli M, Spitz L, Kiely EM, et al. Staged repair of giant omphalocele in the neonatal period. J Pediatr Surg. May 2005;40(5):785-8. [Medline].
Cooney D. Defects of the Abdominal Wall. Pediatr Surg. 1998;2:1045-1070.
Ledbetter DJ. Gastroschisis and omphalocele. Surg Clin North Am. Apr 2006;86(2):249-60, vii. [Medline].
Salihu HM, Boos R, Schmidt W. Omphalocele and gastrochisis. J Obstet Gynaecol. Sep 2002;22(5):489-92. [Medline].
Wakhlu A, Wakhlu AK. The management of exomphalos. J Pediatr Surg. Jan 2000;35(1):73-6. [Medline].
Dykes EH. Prenatal diagnosis and management of abdominal wall defects. Semin Pediatr Surg. May 1996;5(2):90-4. [Medline].
de Lorimier AA, Adzick NS, Harrison MR. Amnion inversion in the treatment of giant omphalocele. J Pediatr Surg. Jul 1991;26(7):804-7. [Medline].
De Ugarte DA, Asch MJ, Hedrick MH, Atkinson JB. The use of tissue expanders in the closure of a giant omphalocele. J Pediatr Surg. Apr 2004;39(4):613-5. [Medline].
Kilbride KE, Cooney DR, Custer MD. Vacuum-assisted closure: a new method for treating patients with giant omphalocele. J Pediatr Surg. Jan 2006;41(1):212-5. [Medline].
Bawazir OA, Wong A, Sigalet DL. Absorbable mesh and skin flaps or grafts in the management of ruptured giant omphalocele. J Pediatr Surg. May 2003;38(5):725-8. [Medline].
Vossoughi F, Reddy PP, Camps J. Acellular dermal tissue matrix in neonates. J S C Med Assoc. Apr 2008;104(4):96-7. [Medline].
Boutros J, Regier M, Skarsgard ED. Is timing everything? The influence of gestational age, birth weight, route, and intent of delivery on outcome in gastroschisis. J Pediatr Surg. May 2009;44(5):912-917. [Medline].
Payne N R, Pfleghaar K, Assel B , Johnson A , Rich R H. Predicting the outcome of newborns with gastroschisis. J Pediatr Surg. May 2009;44(5):918-923. [Medline].
Fok TF, Ng PC, Wong W, et al. High frequency oscillatory ventilation in infants with increased intra- abdominal pressure. Arch Dis Child Fetal Neonatal Ed. Mar 1997;76(2):F123-5. [Medline].
Houben C, Davenport M, Ade-Ajayi N, Flack N, Patel S. Closing gastroschisis: diagnosis, management, and outcomes. J Pediatr Surg. February 2009;44(2):343-347. [Medline].
Sauter ER, Falterman KW, Arensman RM. Is primary repair of gastroschisis and omphalocele always the best operation?. Am Surg. Mar 1991;57(3):142-4. [Medline].
Further Reading
See the eMedicine topic Gastroschisis and the Children's Hospital of Philadelphia's article Gastroschisis.
Keywords
omphalocele, gastroschisis, abdominal wall defect, exomphalos, malabsorption, anomalies of intestinal fixation, midgut volvulus, atypical appendicitis, gastroesophageal reflux, Hirschsprung disease, Beckwith Wiedemann syndrome, trisomy 18, Meckel diverticulum, Meckel's diverticulum, intestinal atresia, prune-belly syndrome, oligohydramnios, pulmonary hypoplasia, bladder exstrophy, colonic atresia, myelomeningocele, hydromyelia, diastematomyelia, diaphragmatic hernia, folic acid deficiency, hypoxia, prematurity, treatment, diagnosis
