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Omphalocele and Gastroschisis in the Newborn

Omphalocele and gastroschisis are two problems that can occur in newborns. They happen when the body structures that are supposed to hold the bowel (intestines) inside the abdomen (belly) do not form correctly. Normally, the body wall and a membrane enclose the bowel inside the abdomen. With omphalocele and gastroschisis, all or part of the bowel develops outside of the baby’s body instead. Other organs may be affected as well. Both of these problems must be repaired with surgery.

 

image of bowel protrouding outside of baby's body, in umbilical cord.

What Is Omphalocele?

With omphalocele, the bowel protrudes outside of the body through a defect in the umbilical cord. A membrane covers the bowel and  protects it from damage and germs. Omphalocele occurs early in the baby’s development. It may be detected on an ultrasound before the baby is born. Even so, the baby can sometimes be delivered vaginally.

Image of bowel sticking out of abdomen through an opening in the abdominal wall.

What Is Gastroschisis?

With gastroschisis, the bowel comes out of the abdomen through a defect (abnormal opening) in the abdominal wall. Other organs may come through as well. There is no membrane covering to protect these organs. So, they’re more likely to become damaged or infected. If your doctor sees gastroschisis on an ulstrasound, he or she will probably deliver your baby by cesarean section. This helps lessen damage to the bowel.

How Are the Problems Treated?

Omphalocele and gastrochisis both require surgery. This often takes place the day the baby is born. Treatment may involve the following:

  • The surgeon moves the bowel and other organs back into the abdomen. The surgeon closes the area of skin where they came through. 

  • If the bowel is damaged, the surgeon may remove a portion before it’s placed back into the abdomen. The surgeon then reconnects the healthy ends of the bowel. 

  • In some cases, the baby’s abdomen is too small to hold all the organs. The surgeon then moves the organs back gradually, to give the abdomen time to grow. More than one surgery may be needed.

  • A health care provider will feed your baby through an IV (intravenous) line until the problem is corrected. IV feeding may continue for some time afterward. Your baby will stay in the neonatal intensive care unit during this time.

What Are the Long-Term Effects?

The long-term effects on your baby may depend on the size of the defect, the  presence of any associated congenital anomalies (abnormalities at birth), and whether any of the bowel must be removed. Long-term feeding problems are possible, but most of these resolve over time. Talk to your doctor about how your baby is likely to progress.

 

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