This document defines and describes congenital umbilical hernias and omphaloceles. It explains that an omphalocele is a weakness in the abdominal wall that allows abdominal contents like the bowel and liver to protrude outside the abdomen. There are two types - minor and major - depending on the size of the defect and contents. Treatment for a minor omphalocele involves primary repair to return the intestines to the abdomen, while a major one requires a staged repair using a mesh sack. Outcomes depend on factors like prematurity and other malformations. Ultrasound during pregnancy can often detect an omphalocele.

2. CONGENITAL
UMBILICAL HERNIA
Omnia M. Korani
2011

3. Definition
 a weakness of the baby's abdominal wall
where the umbilical cord joins it.
 This weakness allows the abdominal
contents, mainly the bowel and the liver to
protrude outside the abdominal cavity.

4. Omphalocele. (Membranous Sac)

5.  During fetal life the intestine develops
inside the umbilical cord and then
usually moves inside the abdomen at
10th week.

6.  Occasionally, the intestine stays inside
the umbilical cord and so develops
outside the abdominal wall.
 Because the contents are lying outside
the abdominal cavity often does not
develop and remains small in size.

7. Congenital umbilical hernia

9.  The presence of an omphalocele is
often associated with other
malformations.
 suggesting that this anomaly is not
a simple failure of umbilical ring
closure.

10. Multiple Malformatins
_ Frontal Encephalocele
_ Dysplastic Ear

11. Omphalocele - Small Penis

12. - Spina bifida

13. Types
Exomphalos major Exomphalos minor

14. E. Minor E. Major
Defect < 5 cm > 5 cm
Content Intestine Viscera + liver
Covering Layer of
wharton’s jelly
+ amniotic
memb.
Amniotic memb.
only .
TTT 1ry repair Staged repair

15. Exomphalos major involving
liver, bowel covered by sac

16. Treatment
 It’s an emergency operation
as fluids and a lot of body heat are lost
through the exposed intestines.
 Type of operation depend on the
type of the abdominal wall defect
(major or minor ).

18.  The goal of the radical cure is to
introduce the viscera into an
abdominal cavity
 they have never occupied before
and maintain them there without
creating intrabdominal
hypertension!!!?

19. Small exomphalos
 ‘primary repair’ under general
anesthesia.
 As a small amount of intestine outside
the abdomen it Takes about 30 min.
 where the surgeons move the
intestines back inside the abdomen
and then close up the muscles and
skin.

20. 1ry repair

21. Large exomphalos
 a ‘staged repair’ as the exophalos is so
large A mesh sack is placed over child’s
intestine, which allows it to be contained
and protected.

22.  This sack is suspended above the
child so that gravity moves the
intestine back inside the
abdomen.
 The sack will be tightened
regularly until all the intestine is
inside the abdomen. This could
take a number of days

23. The abdominal wall defect in
omphalocele is covered with a
synthetic membrane

24. The outcome
There are Associated factors lead to
complications
 prematurity,
 associated malformations
 and finally the risks incurred from the
effects of an abdominal hypertension
following a hasty and forced reduction
of the herniated viscera.

25. Screening
 An omphalocele is often detected
through a detailed fetal
ultrasound.

26. Antenatal ultrasound demonstrates a large protroberancefrom
the anterior abdominal wall, consistent with an omphalocoele.

29. References
 http://congenitalmalformations.blogspot.co
m/
 http://www.gosh.nhs.uk/gosh_families/infor
mation_sheets/abdominal_wall_defects/abd
ominal_wall_defects_families.html
 http://en.wikipedia.org/wiki/Omphalocele

30. ” الحمد لله الذى هدانا لهذا
وما كنا لنهتدى لولا
ان هدانا الله “
الاعراف الاية 43