Abdominal Wall Defects

The two congenital abdominal wall defects most often contrasted in newborn care are gastroschisis and omphalocele. Their appearance tells you what is immediately at risk and what associated problems to look for. | Finding | Gastroschisis | Omphalocele | |---|---|---| | Position | Usually beside the umbilical cord, most often on the right | Midline, at the base of the umbilical cord | | Covering | No protective sac; bowel is exposed directly | Usually covered by a thin membrane or sac | | Contents | Usually bowel | Bowel, stomach, liver, or other abdominal organs | | Associated anomalies | Less commonly associated with major extra-abdominal anomalies | More often associated with cardiac, renal, chromosomal, or syndromic abnormalities | Gastroschisis is the immediate exposure emergency. Without a membrane, the bowel loses heat and fluid, is irritated by amniotic fluid before birth, and can become thickened, swollen, inflamed, and poorly motile. Omphalocele still requires careful protection, but the intact sac provides temporary coverage; the infant’s broader assessment becomes especially important because the visible defect may be accompanied by significant cardiac,...