Omphalocele
Omphalocele is a congenital defect of the abdominal wall. An infant's intestines, liver, or other organs protrude from the abdomen through the navel. The organs are covered with a thin, almost transparent bag that is almost never opened or torn.
As the baby develops during the sixth to tenth weeks of pregnancy, the intestine lengthens and grows from the abdomen into the umbilical cord. At the eleventh week of pregnancy, the intestines normally return to the stomach. If this does not happen, an omphalocele occurs. An omphalocele can be small when only part of the intestine is outside the abdomen, or large when many organs are outside the abdomen.
Other problems
Because some or all of the organs in the abdomen are outside the body, babies born with omphalocele may have other problems. The abdomen, the space in the body that contains these organs, may not reach its normal size. In addition, infection is a concern, especially if the membrane around the organs is damaged. Sometimes the organ can become pinched or twisted, and the loss of blood flow can damage the organ.
Causes and risk factors
The cause of omphalocele in most infants is unknown. In some children, omphalocele occurs due to changes in their genes or chromosomes. Omphalocele can also be caused by a combination of genes and other factors, such as things the mother comes into contact with in the environment, or what the mother eats or drinks, or certain medications she takes during pregnancy.
Diagnosis
Omphalocele can be diagnosed during pregnancy or after the baby is born.
During pregnancy
During pregnancy, screening tests (prenatal tests) are done to check for birth defects and other conditions. An omphalocele can cause an abnormal result on a blood or serum screening test, or it can be seen on an ultrasound.
After the birth of a child
In some cases, an omphalocele may not be diagnosed until the baby is born. Omphalocele is visible immediately at birth.
Treatment
Treatment for infants with omphalocele depends on a number of factors, including
- the size of the omphalocele,
- the presence of other birth defects or chromosomal abnormalities, and
- gestational age of the child.
If the omphalocele is small (only part of the intestine is outside the abdomen), it is usually treated with surgery shortly after birth to push the intestine back into the abdomen and close the hole. If the omphalocele is large (many organs outside the abdomen), repair can be done in stages. Open organs can be covered with a special material, and gradually, over time, the organs will be drawn back into the uterus. When all the organs are placed back into the abdomen, the opening closes.