Neonatal abdominal wall defects

1. Gastroschisis and omphalocele are the most common congenital abdominal wall defects, typically identified on prenatal ultrasound. 2. Fifty to seventy percent of infants with omphalocele have another associated malformation that impacts survival; the survival rate is >90% for those with isolated omphalocele. 3. Semi-analogously, survival for "simple" gastroschisis should be >95%, while "complicated" gastroschisis (those associated with intestinal atresia, perforation, necrosis, or stenosis) will have a less favorable outcome (up to 28% mortality). 4. Operative treatment of gastroschisis varies based on clinical circumstances, institutional resources, and surgeon preference and can include either a variety of options for primary closure or a staged closure using a silo. Bedside closure with a foldover of the umbilical cord stalk to cover the defect can be performed. 5. Omphaloceles are closed primarily when feasible; otherwise, the sac can be allowed to epithelialize via a "paint and wait" approach.