03.08 Abdominal Wall Defects Flashcards Preview

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Flashcards in 03.08 Abdominal Wall Defects Deck (30)
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1

Embryo forms four folds that will enclose the body cavities

4th week

2

Rapit intestinal and liver growth
herniation of midgut into the umbilical cords
Presence of umbilical ceolom

6th week

3

Midgut returns to the abdominal cavity

10th week

4

Failure of the viscera to result to the abdominal cavity

Omphalocoele

5

Failure of lateral fold to develop
Failure of the umbilical coelom to develop
The intestines rupture out of the body wall at the area of the resorbed right umbilical vein

Gastroschisis

6

Gastroschisis is diagnosed thru ____ by ____

Prenatal ultrasound
20 weeks AOG

7

Elevated maternal AFP
No sac
Smaller than omphalocele
Midgut
Born to mothers younger than 21
Preterm delivery

Gastroschisis

8

Most common associated anomalies of gastroschisis

Intestinal atresia

9

Managment of gastroschisis

Early delivery
Neonatal resuscitation and management
Surgery

10

Primary goal is to return the viscera to the abdominal cavity while minimizing the risk of damage to the viscera

Surgery

11

Surgical options

Primary closure
Staged

12

Post-op syndrome when the abdomnial cavity might not be able to handle the sudden increase in volume

Abdominal compartment syndrome

13

Bowels are returned to the abdominal cavity
Fascia and skin are closed

Primary closure

14

Complications of primary closure

Abdominal distention
Abdominal compartment syndrome

15

Can be done bedside without general anesthesia
Makes use of silastic sheets sewn together and sutured to the abdominal wall or a preformed silo with a circular spring

Staged closure or SILO

16

Prevents high intraabdominal pressure and allows early extubation

Staged closure

17

Avoids septic complication of having a foreign body

Primary closure

18

Central abdominal wall defect under umbilical cord
Usually larger than 4 cm in diameter
Always covered by a translucent sac from which the umbilicus extends
Full term

Omphalocele

19

Most common associated anomalies of omphalocele

Cardiac anomaly (VSD, ASD)

20

Syndromes associated with omphalocele

Edwards Syndrome (Trisomy 18)
Beckwith-Wiedemann Syndrome
OEIS (omphalocele, exstrophy of the bladder, imperforate anus, spinal anomalies) syndome
Pentalogy of Cantrell
Cloacal Exstrophy

21

Cephalic fold defect

Pentalogy of Cantrell

22

Five characteristic findings of pentalogy of Cantrell

Omphalocele
Anterior diaphragmatic hernia
Sternal cleft
Ectopia cordis
Intracardiac defect

23

Claustral fold defect
Infraumbilical defect
No spinal deformities

Cloacal exstrophy

24

Management of omphalocele

Perinatal care
Neonatal resuscitation and management
Surgical management

25

Indications of surgery for omphalocele

> 10 cm
Gestational age
Presence of associated anomalies

26

Defect is small
Sac is excised

Primary closure

27

Escharotic therapy

Staged closure

28

Scarificant and disinfectant for staged closure

Silver sulfadiazine
Iodine

29

Umbilicus is intact but there are segments of the bowels going out

Hernia of the umbilical cord

30

Fascial defecct at the umbilicus
Covered by skin
Does not require surgery
Persistence of umbilical ring
Will close spontaneously by 3-4 years old

Umbilical hernia