
Omphaloceles are midline abdominal wall defects with a peritoneal membrane covering the abdominal contents. Gastroschisis occurs usually to the right of the umbilical cord, with eviscerated abdominal contents that are not surrounded by a peritoneal covering. Omphaloceles are associated with numerous congenital anomalies. Both are typically diagnosed on prenatal ultrasound. Gastroschisis and omphalocele defects are covered with saline moistened gauze, and infants with gastroschisis are placed inside a plastic bag-like device. Surgical management of gastroschisis typically consists of placing abdominal contents into the abdominal cavity and repairing the defect primarily or covering to allow closure by second intention healing. If the bowel is too distended, it can be placed within a silo and slowly reduced back into the abdomen prior to closure. Omphalocele repair is more complex and varies by size and associated congenital malformations. The repairs can be described as immediate (small to medium), staged (medium to large), or delayed (giant).
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