Question

Which abdominal wall defect does not involve the umbilical cord? A. Myeloschisis B. Omphalocele C. Meckel diverticulum D. Gastroschisis

Short answer

D. Gastroschisis

Step-by-step solution

Identify Each Condition

First, understand what each condition involves: - Myeloschisis: A neural tube defect involving the spinal cord.- Omphalocele: A congenital defect involving the umbilical cord where the intestines or other abdominal organs protrude outside the abdomen.- Meckel diverticulum: A small pouch on the wall of the lower part of the small intestine, not involving the umbilical cord.- Gastroschisis: An abdominal wall defect where the intestines are found outside the body, typically to the right of the umbilical cord, without being covered by the umbilical cord.

Determine the Involvement of the Umbilical Cord

Next, evaluate whether each condition involves the umbilical cord: - Myeloschisis does not involve the umbilical cord as it is related to the spinal cord.- Omphalocele involves the umbilical cord as abdominal organs protrude through it.- Meckel diverticulum does not involve the umbilical cord.- Gastroschisis does not involve the umbilical cord as the defect is usually adjacent to it.

Select the Appropriate Answer

The correct answer must be an abdominal wall defect that does not involve the umbilical cord. Gastroschisis fits this criteria as it is an abdominal wall defect occurring next to but not involving the umbilical cord.

Key concepts

gastroschisis

Gastroschisis is a congenital defect where the baby's intestines are found outside the body, exiting through a hole next to the umbilical cord. This defect is usually located to the right of the umbilicus. In gastroschisis, the intestines are not covered by any protective sac.

It is noticeable right at birth and requires immediate surgical intervention to place the intestines back inside the abdomen. The exact cause of gastroschisis is not well understood, but it's believed to occur due to problems during the formation of the abdominal wall in early pregnancy.

Parents facing this condition can expect a surgical procedure soon after the baby's birth, followed by a stay in the neonatal intensive care unit (NICU) for proper recovery.

omphalocele

Omphalocele is a type of abdominal wall defect where the intestines, liver, and sometimes other organs remain outside the baby's abdomen in a sac, which protrudes through the umbilical cord.

Unlike gastroschisis, omphalocele is associated with the umbilical cord and covered with a thin, nearly transparent layer of tissue. This condition occurs due to improper closure of the abdominal muscles during fetal development.

Newborns with omphalocele often require surgical intervention to place the organs back inside the abdomen and close the opening. Because it is often associated with other genetic abnormalities, additional medical evaluations might be necessary.

myeloschisis

Myeloschisis is not an abdominal wall defect but a severe form of spina bifida, involving the spinal cord. In myeloschisis, the neural tube fails to close completely during early development, leaving the spinal cord exposed.

This defect can lead to significant neurological impairments and is present at birth. Children with myeloschisis might have mobility issues, bladder and bowel dysfunction, and other complications.

Management often involves surgical repair soon after birth, alongside ongoing therapies and support to address associated deficits.

Meckel diverticulum

Meckel diverticulum is a small pouch present at birth, located on the wall of the lower part of the small intestine. It results from an incomplete obliteration of the vitelline duct during development.

Unlike gastroschisis and omphalocele, Meckel diverticulum does not involve the umbilical cord or cause any protrusion of the intestinal organs. It may not initially present symptoms and in many cases, remains asymptomatic throughout life.

However, complications can arise if the diverticulum becomes inflamed or infected, mimicking symptoms of appendicitis. Surgical removal is necessary if complications occur.