Omphalocele and gastroschisis are congenital abdominal wall defects. Both result from improper closure of the abdominal wall during fetal development but have different characteristics and management needs.

Omphalocele

This is a congenital anomaly in which abdominal organs are located within a membrane-covered sac outside the abdominal wall. The organs are typically enclosed in a protective sac and appear as a swelling around the umbilical area. The incidence is approximately 1 in 5,000 births. It is often detected during routine prenatal screenings. If not detected during pregnancy, the diagnosis is made at birth when an abdominal wall defect with abdominal organs protruding in a sac is observed. Omphaloceles are classified as small or large based on size. Small ones (less than 5 centimeters in diameter) can usually be repaired with a single-stage surgery. Larger defects (greater than 5 centimeters) may require staged surgery or a method where gradual closure is allowed with special devices (such as the silo technique). Surgery should be performed within the first one or two days after birth. If not treated timely and properly, complications such as infections of the abdominal organs, respiratory problems, and circulatory system issues can pose life-threatening risks.

Gastroschisis

In this condition, the abdominal wall is also open, but the intestines protrude outside the abdomen without any covering membrane. This usually occurs through a small opening next to the umbilicus. The incidence is also approximately 1 in 5,000 births and is usually detected by prenatal ultrasound.

The diagnosis and treatment approach are almost the same as for omphalocele. However, it is important to remember that babies with either omphalocele or gastroschisis should be thoroughly evaluated for additional anomalies. These infants have a significantly higher incidence of congenital anomalies involving the heart/circulatory system and urinary system (kidneys and urinary tract) compared to the general population. Therefore, these babies should spend their first hours of life and the initial postoperative days in a neonatal intensive care unit.

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