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Omphalocele

Frank H Miller, MD
Faye C Laing, MD

June 8, 1994

Presentation

In this case from 1989, initial exam at 10 weeks was for vaginal bleeding. Second ultrasound examination was to follow up a suspected anomaly.

Imaging Findings

Initial Ultrasound
Subsequent Examination

In the initial scan at 10 weeks, a prominent protrusion of the anterior abdominal wall (arrow) is visible.

The subsequent examination at 21 weeks shows a large omphalocele (arrows) containing the liver.

Diagnosis

Omphalocele

Discussion

An omphalocele is a defect of the anterior abdominal wall that occurs in approximately 1 in 4,000 births. This defect is covered by a surrounding "membrane" (peritoneum and amnion), and the umbilical ord inserts into the sac. Omphaloceles typically contain bowel and/or liver. In 50-70% of cases, there are associated abnormalities. Chromosomal abnormalities (especially trisomies) are common when an omphalacele contains only bowel.

Omphalocele should be distinguished from gastroschisis, which classically consists of a relatively small, right paraumbilical defect though which eviscerated bowel floats within amniotic fluid. Because associated anomalies and chromosome abnormalities are rare, gastroschisis has a better prognosis than omphalocele.

References

1. Lindors KK, McGahan JP, Walter JP. Fetal omphalocele and gastroschisis: Pitfalls in sonographic diagnosis. AJR 1986; 147:797-800.

2. Schaffer RM, Barone C, Friedman AP. The ultrasonographic spectrum of fetal omphalocele. J Ultrasound Med 1983; 2:210-222.

3. Nyberg DA, Mack LA. Abdominal wall defects. In: Nyberg DA, Mahony BS, Pretorias DH, editors. Diagnostic ultrasound of fetal anomalies. Chicago:Year Book Medical Publishers, 1990:395-432.

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