How is omphalocele differentiated from gastroschisis in congenital abdominal hernias?

Updated: Jul 23, 2019
  • Author: Assar A Rather, MBBS, MD, FACS; Chief Editor: John Geibel, MD, DSc, MSc, AGAF  more...
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Answer

Variants on the definition of hernia exist with regard to congenital abdominal wall defects. An omphalocele is characterized by extension of viscera from the abdominal cavity into the umbilical stalk, with the contents covered by a translucent, bilaminar sac consisting of fused amnion and peritoneum. On occasion, the sac tears prenatally or during delivery, thus becoming harder to identify. The underlying abdominal wall defect exceeds 4 cm. The umbilical vessels insert onto the sac and travel along its left superior aspect to the abdominal wall.

On the other hand, gastroschisis is present when midgut viscera protrude through a central abdominal fascial defect and are not covered by a sac. In this case, the extracorporeal viscera are exposed to the amniotic fluid in utero or to the atmosphere postnatally. The responsible fascial defect is usually less than 4 cm and is almost always immediately to the right and inferior to the umbilicus.


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