Gastroschisis and Omphalocele

00:01 In this very brief lecture, I’m going to review gastroschisis and omphalocele.

00:07 These are the kinds of problems that can show up on exam and that you need to know they exist.

00:12 But generally, exams won't have too much there in about what you have to know about them.

00:16 So I’ll try and review the important information and make this brief.

00:21 So an omphalocele is a midline abdominal wall defect as you can see here.

00:28 The viscera is still in the peritoneal sac.

00:31 This happens in roughly 1 in 5,000 babies.

00:34 So it’s rare, but most largest birthing centers will see one or two a year.

00:40 There are associated anomalies in half of these babies.

00:44 So we should call a geneticist in many cases.

00:47 They may have cardiac anomalies, renal anomalies, skeletal anomalies or even neural tube defects like anencephaly or spina bifida.

00:59 The prognosis varies depending on really the other anomalies.

01:04 The intestinal material can be usually surgically repaired without too much trouble.

01:10 This is compared to the gastroschisis.

01:14 A gastroschisis is a full thickness defect in the abdominal wall.

01:20 The intestinal material is hanging out of the abdomen.

01:24 There is an evisceration of bowel and in this case, there is no covering membrane.

01:30 This is less common.

01:31 It happens in roughly one in ten thousand births.

01:34 Maybe one birth a year in large birthing center.

01:39 These patients have associated defects in a smaller percent of the time, about 10% of the time.

01:45 They may have intestinal atresia or duplication.

01:49 They may have undescended testes.

01:52 These patients have an excellent prognosis if it’s a small defect.

01:57 If it’s a large defect, these infants can run into run some trouble.

02:03 Small defects are generally reduced and have a primary closure, they just sew it up.

02:09 But large defects require a gradual reduction over three to ten days.

02:15 These kids may have other symptoms too such as respiratory distress or need other things in the neonatal intensive care unit.

02:23 So great care has to be provided.

02:26 Surgeons use a silo to gradually reduce gastroschsis.

02:31 So that’s my quick summary of gastroschisis and omphalocele.

02:36 Thanks for your attention.