Abdominal Wall Defects

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Abdominal Wall Defects

 

Definition

Abdominal wall defects are birth (congenital) defects that allow the stomach or intestines to protrude.

Description

Many unexpected and fascinating events occur during the development of a fetus inside the womb. The stomach and intestines begin development outside the baby's abdomen and only later does the abdominal wall enclose them. Occasionally, either the umbilical opening is too large, or it develops improperly, allowing the bowels or stomach to remain outside or squeeze through the abdominal wall.

Causes and symptoms

There are many causes for birth defects that still remain unclear. Presently, the cause(s) of abdominal wall defects is unknown, and any symptoms the mother may have to indicate that the defects are present in the fetus are nondescript.

Diagnosis

At birth, the problem is obvious, because the base of the umbilical cord at the navel will bulge or, in worse cases, contain viscera (internal organs). Before birth, an ultrasound examination may detect the problem. It is always necessary in children with one birth defect to look for others, because birth defects are usually multiple.

Treatment

Abdominal wall defects are effectively treated with surgical repair. Unless there are accompanying anomalies, the surgical procedure is not overly complicated. The organs are normal, just misplaced. However, if the defect is large, it may be difficult to fit all the viscera into the small abdominal cavity.

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.

Prevention

Some, but by no means all, birth defects are preventable by early and attentive prenatal care, good nutrition, supplemental vitamins, diligent avoidance of all unnecessary drugs and chemicals—especially tobacco—and other elements of a healthy lifestyle.

Resources

Periodicals

Dunn, J. C., and E. W. Fonkalsrud. "Improved Survival of Infantswith Omphalocele." American Journal of Surgery 173 (April 1997): 284-7.

Key terms

Hernia — Movement of a structure into a place it does not belong.
Umbilical — Referring to the opening in the abdominal wall where the blood vessels from the placenta enter.
Viscera — Any of the body's organs located in the chest or abdomen.
References in periodicals archive ?
The condition encompasses variably sized 'simple' abdominal wall defects with no associated abnormalities, to those associated with a spectrum of congenitally acquired abnormalities that include BeckwithWiedemann syndrome, 'omphalocoele, extrophy, imperforate anus, spinal' (OEIS) complex and the pentalogy of Cantrell.
14 Both of these can be opted for if the abdominal wall defect is small because of the limitations of local available tissue, needs expertise and have few limitations, while Bogota bag does not have these problems and can be used by the operating surgeon.
Exomphalos and gastroschisis are common congenital anterior abdominal wall defects.
4,5) However, it is very difficult to repair a large (>5 cm) abdominal wall defect without any mesh because the surgeon, according to the classic rules, will attempt to repair the abdominal wall and suture the wound with simple approach stitches.
Many have an abdominal wall defect, such as an umbilical hernia.
Werler says they cannot rule out the possibility that the drug is a marker for something else; perhaps an underlying condition such as the flu actually caused the abdominal wall defect, she says.
The risk of Down's syndrome when the MSAFP is low, or of neural tube defect or anterior abdominal wall defect when the MS-AFP is elevated, is not immediately apparent from unmanipulated data.
This is an abdominal wall defect in which part of an infant's intestines and abdominal organs stick out through the belly button.
Decompression of the bowel and reduction of gut through the existing abdominal wall defect without widening was the primary modality of management; 3-0 vicryl and 3-0 prolene was used for repair.
Multiple surgeries left her with an abdominal wall defect that cannot be repaired, and a permanent hernia.
Associated congenital anomalies in the fetus with gastroschisis are rare except those related to other bowel abnormalities, usually intestinal atresia or stenosis from vascular compromise when the blood supply of the eviscerated bowel is compressed at the abdominal wall defect.
The abdominal wall defect was repaired using laparoscopic separated absorbable sutures.