Birth defects of the abdomen
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Summary
Three types of congenital malformations affecting the abdomen include diaphragmatic hernia (organs extending from the chest), exomphalos (organs extending to the navel) and gastroschisis (organs extending to the abdominal wall).
These conditions can be detected during pregnancy with ultrasound scans.
The causes are unknown, so prevention is not possible.
On this page
Diaphragmatic hernia
Treatment of diaphragmatic hernia
Exomphalos
Treatment of exomphalos
Gastroschisis
Treatment of gastroschisis
Where to get help
The organs of the digestive system - the intestines, stomach, pancreas and liver - are located in the abdomen, separated from the thoracic cavity by the diaphragm. During embryonic development, the diaphragm or abdominal wall may fail to function properly, allowing the abdominal organs to protrude. Three types of congenital malformations affecting the abdomen include diaphragmatic hernia (organs extending from the chest), exomphalos (organs extending to the navel) and gastroschisis (organs extending to the abdominal wall). These conditions can be taken during pregnancy with ultrasound scans. The presence of excess amniotic fluid around the baby (polyhydramnios) may also be a sign of these problems. The causes are unknown, so prevention is not possible.
Diaphragmatic hernia
The diaphragm is a sheet of muscle that is tucked under the lungs. When we breathe, the diaphragm tightens and relaxes. This change in air pressure absorbs air through the lungs as you inhale and exhale through the air as you breathe. Usually, the abdominal organs are located below the diaphragm. Diaphragmatic hernia means that there is an abnormal hole in the diaphragm and the abdominal organs grow inside the ribcage. Lack of space within the chest space and paralysis of the diaphragm structure means that breathing can be difficult. The dense lungs may also have failed to grow properly. At birth, the baby appears cyanotic due to lack of oxygen, and may or may not breathe normally. The stomach also feels softer than it should be. The incidence of diaphragmatic hernia in Victoria is about one in every 2,500 newborns.
Treatment of diaphragmatic hernia
Diaphragmatic hernia is diagnosed by a physical examination and a chest x-ray. This feature can be fatal and the baby needs immediate surgery to remove the abdominal organs and repair the diaphragm. In most cases, the baby should have respiratory support and stay in the hospital longer after surgery. Vision depends on how much the lungs are affected by congestion. The child may be more prone to lung infections.
Exomphalos
The incident of exomphalos in Victoria is almost one in 2,500 XNUMX births. Exomphalos (omphalocele) is an unusual hole in the abdominal wall that allows the intestines and other organs to escape. The organs are covered by the lining of the stomach (peritoneum) instead of the skin. In most cases, a hernia originates in the umbilical cord (umbilicus). The umbilical cord of a newborn baby may be as wide as 10 cm in severe cases, and their genitals may be herniated in the umbilical cord. Estimates vary, but it is estimated that about one third of all children born with exomphalos have other congenital problems, including congenital heart failure.
Treatment of exomphalos
Physical examination alone is often enough to diagnose exomphalos. After giving birth, the baby needs surgery for the first few days of life. If there is insufficient space to repair the hernia immediately, a special bag is sewn around it. The sac shrinks over time, gently squeezing the intestines back into the stomach. The hole can be closed with sutured. The baby may need to stay in the hospital longer.
Gastroschisis
The incidence of gastroschisis in Victoria is about 1 in 4,000 newborns. Gastroschisis is another condition involving the herniated organs, but the feature differs from exomphalos in many ways: it is less likely that there will be other organ problems; a hernia passes through the abdominal wall instead of the navel; and the external organs are not covered with a protective peritoneum. The resulting limbs are sutured or infected, and then covered with wet, sterile cloths as soon as possible after birth. In the worst cases, all the contents of the stomach are found outside the body.
Treatment of gastroschisis
Physical examination alone is often enough to diagnose gastroschisis. After giving birth, the baby needs surgery for the first few days of life. Treatment depends on the level of the hernia and whether there is enough space inside the abdominal area to receive the herniated organs. When the baby's abdomen is big enough, the organs are moved inside the body and the hernia is stitched up. In severe cases, a net bag is sewn near the hernia and corrective surgery is performed over time. If the intestines are damaged, the baby may have digestive problems.
Where to get help
Your doctor
Pediatrician
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