Abdominal wall defect
Encyclopedia
An infant
born
with an abdominal wall defect has an abnormal opening on the abdomen. This often causes the intestines and other organs to form outside of the body.
There are two main types of abdominal wall defects - omphalocele
and gastroschisis
.
. Genetic counseling
and further genetic testing
, such as amniocentesis
, may be offered during the pregnancy as some abdominal wall defects are associated with genetic disorders.
at a rate of one case per 2,000 births, which means that some 2,360 cases are diagnosed per year. Mothers below the age of 20 are four times as likely as mothers in their late twenties to give birth to affected babies.
repair/closure or gastroschisis
repair/closure is not overly complicated. The organs are normal but are misplaced. However, if the abdominal cavity
is too small or when the organs are too large or swollen to close the skin, it may be difficult to fit all the viscera into the small abdominal cavity
. In such cases, the surgeon will place a plastic covering pouch, commonly called a silo because of its shape, over the abdominal organs on the outside of the infant
to protect the organs. Gradually, the organs are squeezed through the pouch into the opening and returned to the body. This procedure can take up to a week, and final closure may be performed a few weeks later. More surgery may be required to repair the abdominal muscles at a later time.
requiring only replacement and strengthening of the passageway through which it occurred. After surgery, increased pressure in the stretched abdomen can compromise the function of the organs inside.
Infant
A newborn or baby is the very young offspring of a human or other mammal. A newborn is an infant who is within hours, days, or up to a few weeks from birth. In medical contexts, newborn or neonate refers to an infant in the first 28 days after birth...
born
Childbirth
Childbirth is the culmination of a human pregnancy or gestation period with the birth of one or more newborn infants from a woman's uterus...
with an abdominal wall defect has an abnormal opening on the abdomen. This often causes the intestines and other organs to form outside of the body.
There are two main types of abdominal wall defects - omphalocele
Omphalocele
An omphalocele is a type of abdominal wall defect in which the intestines, liver, and occasionally other organs remain outside of the abdomen in a sac because of a defect in the development of the muscles of the abdominal wall.-Presentation:The sac, which is formed from an outpouching of...
and gastroschisis
Gastroschisis
Gastroschisis represents a congenital defect characterized by a defect in the anterior abdominal wall through which the abdominal contents freely protrude. There is no overlying sac and the size of the defect is usually less than 4 cm...
.
Diagnosis
These types of openings in the abdomen can usually be detected by AFP screening or a detailed fetal ultrasoundUltrasound
Ultrasound is cyclic sound pressure with a frequency greater than the upper limit of human hearing. Ultrasound is thus not separated from "normal" sound based on differences in physical properties, only the fact that humans cannot hear it. Although this limit varies from person to person, it is...
. Genetic counseling
Genetic counseling
Genetic counseling or traveling is the process by which patients or relatives, at risk of an inherited disorder, are advised of the consequences and nature of the disorder, the probability of developing or transmitting it, and the options open to them in management and family planning...
and further genetic testing
Genetic testing
Genetic testing is among the newest and most sophisticated of techniques used to test for genetic disorders which involves direct examination of the DNA molecule itself. Other genetic tests include biochemical tests for such gene products as enzymes and other proteins and for microscopic...
, such as amniocentesis
Amniocentesis
Amniocentesis is a medical procedure used in prenatal diagnosis of chromosomal abnormalities and fetal infections, in which a small amount of amniotic fluid, which contains fetal tissues, is sampled from the amnion or amniotic sac surrounding a developing fetus, and the fetal DNA is examined for...
, may be offered during the pregnancy as some abdominal wall defects are associated with genetic disorders.
Demographics
Abdominal wall defects occurs in the United StatesUnited States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
at a rate of one case per 2,000 births, which means that some 2,360 cases are diagnosed per year. Mothers below the age of 20 are four times as likely as mothers in their late twenties to give birth to affected babies.
Treatment
Abdominal wall defects can be treated surgically if there is no accompanying anomalies. The surgical procedure also called omphaloceleOmphalocele
An omphalocele is a type of abdominal wall defect in which the intestines, liver, and occasionally other organs remain outside of the abdomen in a sac because of a defect in the development of the muscles of the abdominal wall.-Presentation:The sac, which is formed from an outpouching of...
repair/closure or gastroschisis
Gastroschisis
Gastroschisis represents a congenital defect characterized by a defect in the anterior abdominal wall through which the abdominal contents freely protrude. There is no overlying sac and the size of the defect is usually less than 4 cm...
repair/closure is not overly complicated. The organs are normal but are misplaced. However, if the abdominal cavity
Abdominal cavity
The abdominal cavity is the body cavity of the human body that holds the bulk of the viscera. It is located below the thoracic cavity, and above the pelvic cavity. Its dome-shaped roof is the thoracic diaphragm , and its oblique floor is the pelvic inlet...
is too small or when the organs are too large or swollen to close the skin, it may be difficult to fit all the viscera into the small abdominal cavity
Abdominal cavity
The abdominal cavity is the body cavity of the human body that holds the bulk of the viscera. It is located below the thoracic cavity, and above the pelvic cavity. Its dome-shaped roof is the thoracic diaphragm , and its oblique floor is the pelvic inlet...
. In such cases, the surgeon will place a plastic covering pouch, commonly called a silo because of its shape, over the abdominal organs on the outside of the infant
Infant
A newborn or baby is the very young offspring of a human or other mammal. A newborn is an infant who is within hours, days, or up to a few weeks from birth. In medical contexts, newborn or neonate refers to an infant in the first 28 days after birth...
to protect the organs. Gradually, the organs are squeezed through the pouch into the opening and returned to the body. This procedure can take up to a week, and final closure may be performed a few weeks later. More surgery may be required to repair the abdominal muscles at a later time.
Prognosis
If there are no other defects, the prognosis after surgical repair of this condition is relatively good. However, 10% of those with more severe or additional abnormalities die from it. The organs themselves are fully functional; the difficulty lies in fitting them inside the abdomen. The condition is, in fact, a herniaHernia
A hernia is the protrusion of an organ or the fascia of an organ through the wall of the cavity that normally contains it. A hiatal hernia occurs when the stomach protrudes into the mediastinum through the esophageal opening in the diaphragm....
requiring only replacement and strengthening of the passageway through which it occurred. After surgery, increased pressure in the stretched abdomen can compromise the function of the organs inside.
External links
- Overview at University of SydneyUniversity of SydneyThe University of Sydney is a public university located in Sydney, New South Wales. The main campus spreads across the suburbs of Camperdown and Darlington on the southwestern outskirts of the Sydney CBD. Founded in 1850, it is the oldest university in Australia and Oceania...
- Overview at University of IowaUniversity of IowaThe University of Iowa is a public state-supported research university located in Iowa City, Iowa, United States. It is the oldest public university in the state. The university is organized into eleven colleges granting undergraduate, graduate, and professional degrees...