EXAMPHALOS/ OMPHALOCELE
EXOMPHALOS/ OMPHALOCELE/ UMBILICAL HERNIA OF NEWBORN
- Omphalocele is a failure of midgut as a whole or part to return into coelomic cavity during embryonic life.
- Sac is very thin.
- Sac consis of 3 layers-
a) Outer- amniotic membrane
b) Middle- Whartson’s jelly
c) Inner- Peritoneal layer
- Beckwith- Weidmann syndrome- vitellointestinal anomaly, diaphragmatic hernia, malrotation exists along with exomphalos, macroglossia, gigantism in 2/3rd of babies.
- Chromosomal trisomies- 13, 15, 18, 21
- Abdominal wall- normal and peritoneal layer- hypoplastic
TYPES-
- Examphalos minor-
- Sac is small and umbilical cord is attached to the summit
- Sac has a defect (<5cm)
Treatment-
- Twisting the cord and ligating the sac and abdomen is strapped.
- Defect is closed.
2. Examphalos major-
- Large defect (>5cm) is present outside completely.
- Umbilical cord is attached to the inferior aspect of the sac.
- Children are usually still- born
- Hernia associated with absent abdominal musculature.
- Sac contains intestine and abdominal viscera
- High mortality
Treatment-
- Immediate surgery required
Exam Important
TYPES-
- Examphalos minor-
- Sac is small and umbilical cord is attached to the summit
- Sac has a defect (<5cm)
Treatment-
- Twisting the cord and ligating the sac and abdomen is strapped.
- Defect is closed.
2. Examphalos major-
- Large defect (>5cm) is present outside completely.
- Umbilical cord is attached to the inferior aspect of the sac.
- Children are usually still- born
- Hernia associated with absent abdominal musculature.
- Sac contains intestine and abdominal viscera
- High mortality
Treatment-
- Immediate surgery required
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