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 ?
In our experience the preoperative study based on computed tomography is essential for the diagnosis of the gallbladder hernia, and it provides also additional information on the abdominal wall defect.
In repair of abdominal wall defects biological biomaterials has an edge over synthetic prosthetic materials like minimal adhesion formation, better framework for fibroblast proliferation and neovascularization and moreover multidirectional fibrous structure helps in better suture retention and are completely absorbed in body and replaced by host tissue [1].
The sternal and abdominal wall defects represent faulty migration of these mesodermal primordial structures.
Complications associated with these costly materials, such as rapid break down and loss of the graft material, especially in infected fields, and undesirable host foreign body reaction have been reported in animal and human studies when used to repair abdominal wall defects (1).
An a priori decision was made to analyze the following common subgroups of anomalies: neural tube defects (Q00, Q01, Q05), congenital heart disease (Q20-Q26), respiratory system defects (Q30-Q34), orofacial clefts (Q35-Q37), digestive system defects (Q38Q38, Q402-Q409, Q41-Q45, Q790), abdominal wall defects (Q792, Q793, Q795), urinary system defects (Q60-Q64, Q794), hypospadias (Q54), and limb reduction defects (Q650-652, Q658-Q659, Q660, Q681-Q682, Q688, Q69-Q74).
According to the abstract, abdominal wall defects continue to be a challenging problem for reconstructive surgeons.
A population based study of abdominal wall defects in South Australia and Western Australia.
laparoscopic hernia repair techniques; and complex reconstructions, including the management of fistulae, postoperative bulge, recurrent hernia, and other abdominal wall defects, ending with a chapter on composite tissue allotransplantation.
Omphalocele is one of the most common fetal abdominal wall defects.
Some anomalies require surgery after birth regardless of whether they are treated in utero, such as abdominal wall defects, bowel obstruction, or cervical teratoma.
His other area of major interest is in hernia surgery and reconstruction of abdominal wall defects.
Although pregnant women have used the decongestant pseudoephedrine (Sudafed) for years, recent reports suggest a slight increase in abdominal wall defects in newborns, so it's suggested women avoid oral decongestants during the first trimester.