A newborn has a large central abdominal wall defect containing liver and bowel. The viscera are covered by a glistening membrane composed of peritoneum and amnion, and the cord inserts onto the apex of the sac. Which statement is true of this condition compared with gastroschisis?

• A The eviscerated bowel is typically thickened, matted, and covered with a fibrinous peel
• B It carries a higher incidence of associated chromosomal and cardiac anomalies ✓
• C It is more commonly associated with maternal young age and smoking
• D The defect is always located to the right of the umbilicus

Explanation

Omphalocele is a herniation through a persistent umbilical ring into a covering sac, arising from failure of return of midgut to the coelomic cavity, so other organ systems are frequently malformed, including cardiac defects and trisomy 13, 18, and Beckwith-Wiedemann syndrome. Gastroschisis lacks a sac, lies right of the umbilicus, shows inflamed matted bowel from amniotic exposure, and has few associated anomalies. Options A and D describe gastroschisis.

Reference: Pediatric Surgery NaT, APSA ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.