Abdominal wall defect

Abdominal wall defect
Classification and external resources
ICD-10	Q79
ICD-9	756.7

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.

Diagnosis

These types of openings in the abdomen can usually be detected by AFP screening or a detailed fetal ultrasound. 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.

Demographics

Abdominal wall defects occurs in the United States 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 omphalocele 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.

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 hernia 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.

See also

• Abdominal wall

External links

• Overview at University of Sydney
• Overview at University of Iowa