A newborn is found to have a large central abdominal wall defect containing liver and bowel, covered by a thin translucent membrane through which the umbilical cord inserts directly into the sac. Which statement best describes this condition?

• A The bowel is never covered by any membrane and the defect lies to the right of the umbilicus
• B The viscera are covered by a sac of amnion over peritoneum, and chromosomal and cardiac anomalies are common ✓
• C Associated congenital anomalies are rare compared with gastroschisis
• D It results from intrauterine vascular accident causing ischemic necrosis of the abdominal wall

Explanation

Omphalocele is a herniation through the umbilical ring into a sac composed of peritoneum lined internally and amnion externally, with the cord inserting onto the sac. Because it arises from failure of return of midgut to the coelomic cavity during embryogenesis, it is strongly associated with cardiac defects, chromosomal anomalies and Beckwith-Wiedemann syndrome. Gastroschisis, option A, has no covering membrane, a paraumbilical defect usually to the right of the cord, and far fewer associated anomalies.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.