Omphalocele

Definition

An omphalocele is an abnormality in newborns in which the infant’s intestine or other abdominal organs protrude from the navel. The intestines are covered only by abdominal membrane, and can be easily seen.

Causes, incidence, and risk factors

Birth defects occur in approximately 25 - 40% of infants with an omphalocele, and they may include genetic problems (chromosomal abnormalities), congenital diaphragmatic hernia, and heart defects.

Symptoms
An omphalocele is clearly evident by a defect in the abdominal wall at the navel through which the abdominal contents protrude. There are different sizes of omphaloceles. Smaller ones have only intestine protruding, while larger ones may have the liver or spleen protruding as well.

Signs and tests
Prenatal ultrasounds often identify infants with an omphalocele before birth. Otherwise, physical examination of the infant is sufficient for your health care provider to diagnose this condition. Testing is usually not necessary.

Treatment

Omphaloceles are surgically repaired, although not always immediately. The sac protects the abdominal contents and allows time for other more serious problems (such as heart defects) to be dealt with first, if neccessary.

To fix an omphalocele, the sac is covered with a special silo, which is then stitched in place. Slowly, over time, the volume of the silo is decreased and the abdominal contents are pushed into the abdomen.

When the omphalocele can comfortably fit within the abdominal cavity, the synthetic material is removed and the abdomen is closed.

Expectations (prognosis)
Complete recovery is expected. Frequently, omphalocele can be associated with other birth defects, and the prognosis then depends on these conditions.

Complications

     
  • Intestinal infection  
  • Death of the intestinal tissue related to dryness or trauma to the unprotected intestine

Calling your health care provider
This problem is diagnosed and repaired in the hospital at birth. After returning home, call your health care provider if the infant develops any of these symptoms:

     
  • Feeding problems  
  • Vomiting (not normal baby spitting-up)  
  • Green or yellowish green vomitus  
  • Distended abdomen  
  • Decreased bowel movements  
  • Fever  
  • Behavioral changes that are worrisome

Johns Hopkins patient information

Last revised: December 4, 2012
by Janet G. Derge, M.D.

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