pediatric omphalocele and gastroschisis differential diagnoses

13/5/2015 PediatricOmphaloceleandGastroschisisDifferentialDiagnoses

http://emedicine.medscape.com/article/975583differential 1/3

PediatricOmphaloceleandGastroschisisDifferentialDiagnoses

Author:JamesGGlasser,MD,MA,FACSChiefEditor:TedRosenkrantz,MDmore...

Updated:Apr28,2015

DiagnosticConsiderationsNotethatventralbodywalldefectsareimmediatelyobvious.However,althoughthediagnosisissimple,treatmentofthesedefectsiscomplex.

Omphalomesentericductremnants,occasionallyassociatedwithintestinalatresia,occurinbabieswithumbilicalcordhernias,inwhichtheabdominalwalldefectislessthan4cm.

Theassociationofchromosomalabnormalitieswithomphaloceleis1050%.Thisincludestrisomy12,13,15,18,and21andBeckwithWiedemannsyndrome.

Geneticabnormalitiesrarelyoccurinbabieswithgastroschisis,buttheclinicalcourseoftheseinfantsisfrequentlycomplicatedbymalabsorptionandintestinaldysmotility,gastroesophagealrefluxdisease,andoccasionallyHirschsprungdisease.

Specialconcerns

Withtheincreasedavailabilityofultrasonography,prenataldiagnosisismademorefrequently.

Whenanomphaloceleisdiagnosed,furtherworkupisindicatedtodeterminewhetheranassociatedgeneticabnormalityispresent.

Whengastroschisisisdiagnosed,serialultrasonographyshouldbeperformedtodetectsignsofintestinalinjury,includingdecreasedperistalsisorboweldistension.

Parentsshouldbeeducatedaboutthebaby'sanomalybeforedelivery.Optimalmanagementrequiresthattheobstetriciananticipatestheneedsofthebabyandensuresthatdeliveryoccursinafacilitywhereneonatology,pediatricanesthesia,andpediatricsurgeryconsultationisavailable.

ContributorInformationandDisclosuresAuthorJamesGGlasser,MD,MA,FACSAssociateProfessorofSurgeryandPediatrics,UniversityofSouthAlabamaCollegeofMedicineAttendingStaff,USAChildren'sandWomen'sHospital

JamesGGlasser,MD,MA,FACSisamemberofthefollowingmedicalsocieties:AmericanPediatricSurgicalAssociationandChristianMedical&DentalSociety

Disclosure:Nothingtodisclose.

SpecialtyEditorBoardDavidNSheftelMD,AssistantProfessorofPediatrics,ChicagoMedicalSchoolatRosalindFranklinUniversityofMedicineandScience

DavidNSheftelisamemberofthefollowingmedicalsocieties:AmericanAcademyforCerebralPalsyandDevelopmentalMedicineandAmericanAcademyofPediatrics

Disclosure:Nothingtodisclose.

MaryLWindle,PharmDAdjunctAssociateProfessor,UniversityofNebraskaMedicalCenterCollegeofPharmacyEditorinChief,MedscapeDrugReference

Disclosure:Nothingtodisclose.

BrianSCarter,MD,FAAPProfessorofPediatrics,UniversityofMissouriKansasCitySchoolofMedicineAttendingPhysician,DivisionofNeonatology,Children'sMercyHospitalandClinicsFaculty,Children'sMercyBioethicsCenter

BrianSCarter,MD,FAAPisamemberofthefollowingmedicalsocieties:AlphaOmegaAlpha,AmericanAcademyofHospiceandPalliativeMedicine,AmericanAcademyofPediatrics,AmericanPediatricSociety,AmericanSocietyforBioethicsandHumanities,AmericanSocietyofLaw,Medicine&Ethics,NationalHospiceandPalliativeCareOrganization,andSocietyforPediatricResearch

Disclosure:Nothingtodisclose.

CarolLWagner,MDProfessorofPediatrics,MedicalUniversityofSouthCarolina

CarolLWagner,MDisamemberofthefollowingmedicalsocieties:AmericanAcademyofPediatrics,AmericanChemicalSociety,AmericanMedicalWomen'sAssociation,AmericanPublicHealthAssociation,AmericanSocietyforBoneandMineralResearch,AmericanSocietyforClinicalNutrition,MassachusettsMedicalSociety,NationalPerinatalAssociation,andSocietyforPediatricResearch

Disclosure:Nothingtodisclose.

13/5/2015 PediatricOmphaloceleandGastroschisisDifferentialDiagnoses

http://emedicine.medscape.com/article/975583differential 2/3

ChiefEditorTedRosenkrantz,MDProfessor,DepartmentsofPediatricsandObstetrics/Gynecology,DivisionofNeonatalPerinatalMedicine,UniversityofConnecticutSchoolofMedicine

TedRosenkrantz,MDisamemberofthefollowingmedicalsocieties:AmericanAcademyofPediatrics,AmericanMedicalAssociation,AmericanPediatricSociety,ConnecticutStateMedicalSociety,EasternSocietyforPediatricResearch,andSocietyforPediatricResearch

Disclosure:Nothingtodisclose.

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