Infant omphalocele
Infant omphalocele

Omphalocele

Definition:
An omphalocele involves herniation (displacement) of the intestine or other abdominal contents through the umbilical root, which is covered only by peritoneum (the abdominal membrane) rather than skin.

Causes, incidence, and risk factors:

An omphalocele is a relatively frequent abnormality of the newborn that occurs in approximately 1 in 5,000 births. If this condition is present, the intestines can be easily seen through the translucent peritoneal membrane.

Significant associated birth defects occur in approximately 25-40% of infants with an omphalocele, and they include genetic problems (chromosomal abnormalities), congenital diaphragmatic hernia, and heart defects.

Symptoms:
A defect in the abdominal wall at the navel through which the abdominal contents protrude indicates an omphalocele. There are different sizes of omphaloceles. Smaller ones have only intestine protruding, while larger ones may have the liver or spleen protruding as well.
Signs and tests:
Prenatal ultrasounds often identify infants with an omphalocele before birth. Otherwise, Physical examination of the infant is sufficient for your health care provider to diagnose this condition. Testing is usually not necessary.
Treatment:

Omphaloceles are surgically repaired, although not always immediately. The sac protects the abdominal contents and allows time for other more serious problems (such as heart defects) to be dealt with first, if neccessary.

To fix an omphalocele, the sac is covered with a special silo, which is then stiched in place. Slowly over time the volume of the silo is decreased and the abdominal contents are pushed into the abdomen.

When the omphalocele can comfortably fit within the abdominal cavity, the synthetic material is removed and the abdomen is closed.

Expectations (prognosis):
Complete recovery is expected. Frequently, omphalocele can be associated with other birth defects, and the prognosis then depends on these conditions.
Complications:
  • Intestinal infection
  • Death of the intestinal tissue related to dryness and trauma to the unprotected intestine
Calling your health care provider:
This problem is diagnosed and repaired in the hospital at birth. After returning home, call your health care provider if the infant develops any of these symptoms:
  • Feeding problems
  • Vomiting (not normal baby spitting)
  • Green or yellowish green vomitus
  • Distended abdomen
  • Decreased bowel movements
  • Fever
  • Behavioral changes that you find worrisome

Review Date: 7/30/2002
Reviewed By: Jonathan Fanaroff, M.D., Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH. Review provided by VeriMed Healthcare Network.
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