Differences Between Omphalocele and Gastroschisis

Sir.—Colombani and Cunningham's¹ well-documented series of abdominal wall defects offers some interesting new information about the maternal and perinatal differences between omphalocele and gastroschisis. The pathological findings in their patient group are consistent with numerous other reports in the literature. In their criticism of my article,² however, they miss its major point. I do not consider omphalocele and gastroschisis to be the same clinical entity. Indeed, my article emphasizes the clinical differences first pointed out by Moore.³ "The myth of gastroschisis," to which I refer, does not deny the reality of gastroschisis, but simply seeks to substitute a more rational theory of embryogenesis for those currently in the literature. My point is that although there are clinical differences between gastroschisis and omphalocele and although the factors causing them undoubtedly differ, the clinical evidence suggests that gastroschisis is, like omphalocele and hernia of the umbilical cord (or