Abdominal Wall Defects (Pediatric)
What are abdominal wall defects?
Abdominal wall defects occur when there is an opening in the abdomen through which other organs jut out, such as the stomach or intestines. This condition is present at birth. Types of abdominal wall defects are:
- Gastroschisis: Contents of the abdomen protrude out of the body through an opening in the abdominal muscles near the umbilical cord. Without a protective covering, the organs are exposed to amniotic fluid and may swell or become damaged.
- Omphaloceles: Organs of the abdomen protrude out of the body through an opening in the abdominal muscles near the umbilical cord insertion into the body. These organs are covered by a clear sac or membrane. Omphaloceles may be small (more common) or giant (less common).
How are abdominal wall defects diagnosed?
- Routine ultrasounds during pregnancy usually find abdominal wall defects.
- For omphaloceles, we may recommend fetal echocardiography and genetic counseling due to the high association of this defect with additional abnormalities and genetic conditions.
What is the treatment for abdominal wall defects?
- Treatment for gastroschisis entails protecting the organs with a sterile sheet known as a “silo” and gradually placing them back into the abdomen, at which time our pediatric surgeons often avoid formal surgery by covering the defect with the baby’s own umbilical cord. Overall, most children with gastroschisis have full, active lives with no long-term health problems.
- Treatment for small omphaloceles entails surgical repair shortly after birth. Intestines are returned to the abdomen and the opening is closed. With giant omphaloceles, exposed organs are allowed to gradually reduce into the abdomen taking advantage of the baby’s own covering membrane. Formal repair is done in 6-12 months avoiding any stressful surgery in the newborn period.