Omphalocele
Everything in the library about omphalocele — built automatically from the recorded discussions that name it
Educational content from recorded physician discussions — not medical advice. Always talk to your child's care team about your child's situation.
Content of this collection
Fundamentals
2 items
Omphalocele and Gastroschisis With Dr. Foong-Yen Lim
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Omphalocele and Gastroschisis are abdominal wall defects that develop in-utero and surgically treated post-birth. Join Dr. Foong-Yen Lim, Surgical Director of the Cincinnati Children’s Fetal Care Center, and Dr. Todd Ponsky to discuss the p
podcast9:31 · Feb 2022
Omphalocele & Gastroschisis
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Abdominal wall defects like omphalocele and gastroschisis can lead to potentially complex postnatal care which is why today we are going to discuss some key knowledge points from Dr. Foong-Yen Lim: pediatric surgeon at Cincinnati Children’s
video9:32 · Mar 2022
Surgical Management
3 items
Abdominal Wall Defects
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Dr. Jacob Langer discusses various abdominal wall defects through case presentation.Topics of discussion include atresia, gastroschisis, fascial defects, staged closure by silo, and ruptured omphalocele.
video37:50 · Nov 2018
Gastroschisis: Advanced Practice Providers
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Joyce Slusher, MSN, CNP, presents on perioperative management of gastroschisis for advanced practice providers.
video43:21 · Jan 2019
Gastroschisis - Clinical Practice Updates
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This clip from the 2020 Pediatric Surgery Update Course features, Miguel Guelfand, MD; Shawn St. Peter, MD; and Saleem Islam, MD; presenting challenging cases for review by our panelists.
Highlighted Topics Include:
- Omphalocele
- Pul
video · Sep 2020
Complications
1 item
Error Traps and Culture of Safety in Abdominal Wall Defects
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This video highlights a few key points from the "Error Traps and Culture of Safety in Abdominal Wall Defects" article published in Seminars in Pediatric Surgery, provided by lead author Dr. Sherif Emil . Find the full article at: www.scienc
video · Oct 2019
Case-Based Learning
1 item
Abdominal Wall Defects: Update Course 2013
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Dr. Jacob Langer discusses various abdominal wall defects through case presentation.Topics of discussion include atresia, gastroschisis, fascial defects, staged closure by silo, and ruptured omphalocele.
video37:40 · Jan 2019
In-Depth Reviews
2 items
Abdominal Wall Defects with Dr. Jacob Langer
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Dr Jacob Langer discusses abdominal wall defects with Dr. Todd Ponsky.Edited by Ian C. Glenn, MD and Sophia Abdulhai, MDAn interactive discussion about gastroschisis and omphalocele between Todd Ponsky, MD and Jacob "Jack" Langer, MD. Dr. L
podcast52:45 · Jan 2019
Abdominal Wall Defects with Dr. Jacob Langer
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Dr Jacob Langer discusses abdominal wall defects with Dr. Todd Ponsky.Edited by Ian C. Glenn, MD and Sophia Abdulhai, MDAn interactive discussion about gastroschisis and omphalocele between Todd Ponsky, MD and Jacob "Jack" Langer, MD. Dr. L
podcast52:45 · Dec 2020
Patient & Family Education
1 item
What is Omphalocele? An ERNICA animation for parents and families
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Animation video [in English]. Target audience: Parents and families. The video could also be used as an explanatory tool by healthcare professionals.
For further details about this condition, possible complications and specialised care,
video3:19 · Dec 2023
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All expert statements+ Show
Every expert statement below comes from the recorded discussions, with its speaker and moment.
Abdominal Wall Defects with Dr. Jacob Langer
The frequency and incidence of abdominal wall defects appears to be increasing
host_summary0:00 ↗
With gastroschisis, the main issue is that the bowel gets damaged through fetal life
clinicalJack Langer4:36 ↗
Most gastroschisis patients don't have any other associated anomalies, and it's pretty rare to have abnormal chromosomes
clinicalJack Langer4:46 ↗
Early papers showed a benefit to cesarean section in gastroschisis, but cesarean sections were usually done early at 36 or 37 weeks, raising the question of whether timing rather than cesarean section itself gave the benefit
clinicalJack Langer5:46 ↗
Many studies have failed to show an advantage to cesarean section, and most people nowadays would not do routine cesarean section for gastroschisis
clinicalJack Langer6:13 ↗
There has not been any large randomized trial looking specifically at the issue of early delivery in gastroschisis
clinicalJack Langer6:29 ↗
Toronto's approach is to deliver gastroschisis patients at around 37 weeks unless they've already gone into spontaneous labor
clinicalJack Langer6:58 ↗
The mean gestational age of onset of labor is a lot earlier in gastroschisis pregnancies, possibly because of inflammatory mediators produced by the inflamed bowel
clinicalJack Langer7:07 ↗
In gastroschisis pregnancies, labor can usually be successfully induced at 37 weeks, unlike regular pregnancies
clinicalJack Langer7:30 ↗
Most evidence, including from the CapsNet database, suggests that delivery in a perinatal center is beneficial for gastroschisis
clinicalJack Langer8:36 ↗
During transport of gastroschisis patients, it's important for the baby to be nursed on his or her side, usually right side down, to prevent kinking of the mesentery and ischemia of the bowel
clinicalJack Langer10:01 ↗
For gastroschisis, bedside closure is the first choice if the bowel is not too thickened and there's not too much peel
clinicalJack Langer10:57 ↗
Adrian Bianchi first described bedside closure for gastroschisis
clinicalJack Langer11:21 ↗
Using forceps at the bedside to push bowel back in can damage the bowel in a squiggling baby
clinicalJack Langer11:29 ↗
The current approach uses pre-formed silos, slowly pushing on them with fentanyl or morphine sedation in an awake baby, aiming to keep intraabdominal pressure below 20
clinicalJack Langer11:47 ↗
If reduction is successful with good pressure and perfusion, the silo can be removed immediately and the umbilical cord stump used to cover the hole with a Duoderm dressing left for about 5 days
clinicalJack Langer12:27 ↗
The sutureless plastic closure technique was described by Anthony Sandler and doesn't require suturing the umbilical cord
host_summaryTodd Ponsky13:15 ↗
A study by Dr. Baird published in JPS showed that patients with flap closure did better in every way than those with sutured fascial closure, including lower rates of umbilical hernia repair
host_summaryTodd Ponsky14:19 ↗
Umbilical hernias from plastic closure generally close by age 2 or 3 years, just like any umbilical hernia
clinicalJack Langer14:56 ↗
Some gastroschisis patients become tachypneic with bluish legs after reduction and require intubation by neonatologists an hour or two later
clinicalJack Langer16:12 ↗
The disadvantage of leaving a silo on for 24-48 hours is that the abdominal wall defect gets stretched out and bigger, taking longer to close with plastic closure
clinicalJack Langer17:25 ↗
Spring-loaded silos apply pressure outward as you push down, making the defect larger over time
clinicalTodd Ponsky18:10 ↗
The incidence of intestinal atresia in gastroschisis is between 5 and 10%
epidemiologicalJack Langer18:51 ↗
There are two types of intestinal atresia in gastroschisis: early-onset atresia where bowel gets very dilated but not thick-walled, and late atresia where the abdominal wall defect becomes very small causing ischemia and potentially vanishing gastroschisis
clinicalJack Langer19:01 ↗
The prognosis for short bowel syndrome has improved dramatically over the last 10-15 years because of intestinal failure centers, better TPN that doesn't damage the liver as much, and control of sepsis
clinicalJack Langer20:15 ↗
For atresia in gastroschisis, there are three management choices: repair at time of closure, bring out stomas, or drop everything back in and repair the atresia later
clinicalJack Langer20:54 ↗
There's no good evidence for optimal management of atresia in gastroschisis because it's such a rare occurrence
opinionJack Langer21:15 ↗
If bowel looks good without much peel, primary repair of atresia at initial closure is appropriate; if there's concern, drop it back in and repair later
clinicalJack Langer21:35 ↗
Stomas are brought out only when there's necrotic bowel requiring resection and the bowel is not healthy enough to anastomose
clinicalJack Langer22:01 ↗
The umbilicus is the preferred site for neonatal stomas because it results in a scar that would have been there anyway and is convenient for appliance placement
clinicalJack Langer22:50 ↗
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