Similarities and differences between omphalocele and gastroschisis?

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1. Similarities and differences between omphalocele and gastroschisis?

Similarities :-

Omphalocele or Gastroschisis are congenital defects of the anterior abdominal wall.They share one major characteristic. In both conditions, a baby's intestines extend out of a hole in the belly. In some cases, other organs like the liver or stomach also push out through the hole.

Differences :-

Omphalocele

· Location : center

· Presence of peritoneum-amniotic membrane

· Umbilical cord inserted in caudal area

· Fetopathy

· Content : intestine, liver, spleen, colon, bladder occasionally

· Frequently associated with other congenital anomalies (40-80%)

· Associated anomalies include intestinal atresia (mechanical)

Gastroschisis

· Location : right side

· Content not covered by membranes

· No umbilical cord

· Embryopathy

· Content : intestine, colon, bladder and gonads occasionally

· Rarely associated with other congenital anomalies (15%)

· Associated anomalies include chromosomal, cardiac, pulmonary hyperplasia

2. Preoperative preparation in a child with omphalocele and gastroschisis.

Omphalocele :-

· For a large omphalocele, closure is done months after birth and on a scheduled basis. At this time, there is usually mature skin covering the omphalocele sac. A bath or shower the night prior to or the morning of the operation is encouraged. The infant will receive antibiotics through the vein to decrease infection.

· For a small omphalocele, closure is done a few days after birth. The infant will receive antibiotics through the vein to decrease infection.

Gastroschisis :-

• AIRWAY SUPPORT - Often intubated in delivery room

• GASTRIC DECOMPRESSION - Prevent aspiration ; Air progressing past pylorus where irretrievable and cause increased difficulty in repair

• TEMPERATURE REGULATION - Infant covered with plastic wrap to minimize heat loss

• BOWEL CARE - Bowel covered by moist saline dressing, protect from dehydration ; Care to be taken not to twist bowel – impair vascular integrity.

• Inspect the protruding viscera, R/O torsion or angulation of bowel

• Correct dehydration / hypovolemia / hypoglycemia

• Evaluation respiratory system (Chest X-ray)

• Cardiac evaluation (EKG, ECHO, especially in Omphalocele)

• Temperature stabilization

• Evaluation intravascular status

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