January 1965

Surgical Therapy of Omphalocele And Gastroschisis

Author Affiliations

From the Department of Surgery, Yale University School of Medicine. Instructor of Surgery (Dr. Hutchin); Associate Professor of Surgery (Dr. Goldenberg).

Arch Surg. 1965;90(1):22-28. doi:10.1001/archsurg.1965.01320070024005

OMPHALOCELE and gastroschisis are rare congenital anomalies of the anterior abdominal wall (Fig 1 and 2) which result from a disturbance in the mechanism of embryonic abdominal wall closure.11 In omphalocele, herniation of the abdominal contents occurs into the base of the umbilical cord which provides a covering of amnion for the herniated viscera.32 The thin hernial sac is prone to rupture either antenatally or postnatally. In gastroschisis, there is normal insertion of the umbilical cord, no remnants of amniotic sac are present, and the abdominal viscera herniate outside of the abdomen through an extra-umbilical defect in the abdominal wall.29 The herniated viscera of gastroschisis and of omphalocele ruptured in utero invariably show evidence of peritonitis of varying degree. The exteriorized bowel loops are thickened, edematous, matted together and covered with a slimy gelatinous exudate.

Hernia into the umbilical cord, amniocele, exomphalos, and umbilical eventration have

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