Abdominal Wall Defects

Abdominal wall defects are a type of birth defect that allow the digestive organs—such as the stomach or intestines—to push out of the body through an abnormal opening in the abdomen. It is normal for digestive organs to begin growing outside the abdomen during fetal development. As development continues, the organs should move into the abdomen and become enclosed by the abdominal wall. An abdominal wall defect occurs when the wall does not close normally, which allows some organs to remain outside the abdomen.

There are two main types of abdominal wall defects:

Omphalocele. An omphalocele is when organs protrude through the middle of the abdominal wall at the belly button (umbilicus), protected only by a thin membrane or sac. In some cases, only some organs are exposed. In severe cases, most or all of the digestive organs are exposed. An omphalocele is often accompanied by other birth defects and genetic syndromes. If your doctor discovers an omphalocele prenatally, he or she may recommend genetic testing. Genetic testing can provide better information about your baby's condition. Riley at IU Health provides genetic testing through the Prenatal Diagnosis Program.
Gastroschisis. With gastroschisis, the abdominal wall does not completely close which allows part of the intestines to protrude unprotected through a hole near the belly button. Unlike an omphalocele, there is no protective sac around the organs. In extreme cases, part of the stomach and/or liver may also protrude. Gastroschisis is not generally linked to any genetic syndrome.

Symptoms of an abdominal wall defect may include:

Abdominal organs visibly protrude out through the skin, possibly covered by a thin membrane
A bulging or bubbled appearance around the baby’s umbilical cord
Digestive problems due to poor circulation and irritation of the digestive organs as a result of their location outside the body

With either type of abdominal wall defect, there is a risk of injury and infection because the organs are not protected inside the body as they should be. There is also a risk that parts of the digestive system could be pinched or twisted, which compromises blood supply. A loss of blood flow to the digestive system can cause serious problems.

Diagnosis of Abdominal Wall Defects

Abdominal wall defects are commonly identified and diagnosed through prenatal ultrasound during the second trimester of pregnancy. If a prenatal ultrasound detects that your baby will have an abdominal wall defect, a multidisciplinary team of specialists in maternal fetal medicine, neonatology, pediatric surgery and other specialties will develop a care plan for your baby’s delivery, including treatment in the neonatal intensive care unit (NICU).

Abdominal wall defects are visible during a physical examination at birth. Your baby’s doctor may assess the severity of the condition through X-ray imaging, performed shortly after birth.

Treatments

When a baby has an abdominal wall defect, the rest of the abdomen may be small and underdeveloped. In many cases, there is not enough room in the abdomen to immediately move the organs back inside the body and correct the defect. The organs must remain outside the body for a few days after birth to give the abdomen time to grow.

When immediate surgery is not an option, sterile protective sheeting is placed over the organs, and a device called a silo is put in place to provide an extra protective layer. A silo houses and protects the protruded organs until the abdomen grows enough to contain the digestive organs. Your baby may also receive breathing help from a machine called a mechanical ventilator while he or she is waiting for surgery.

Once it is safe for your baby to have the abdominal wall defect corrected, a surgeon gently places the digestive organs back into the abdomen and repairs the opening in the abdominal wall. This usually happens a few days to a week after birth.

Dietitians who specialize in treating babies with abdominal wall defects can work with you to find feeding options that provide adequate nourishment and lessen any irritation.

Some babies with abdominal wall defects may develop short bowel syndrome, a condition that occurs when part of the small intestine is missing or not absorbing nutrients. The Intestinal Care Program at Riley at IU Health provides specialized treatment for babies and children with short bowel syndrome.

Key Points to Remember

Abdominal wall defects are a type of birth defect that allow the digestive organs—such as the stomach or intestines—to protrude through an abnormal opening in the abdomen.
Omphalocele and gastroschisis are the two main types of abdominal wall defects.
Abdominal wall defects are normally diagnosed using a prenatal ultrasound before birth.
Surgery to treat abdominal wall defects must wait until your baby’s abdomen grows enough to contain the organs, usually a few days after birth.

Support Services & Resources

These resources provide additional information and support for families of babies and children with abdominal wall defects.

Riley at IU Health offers a broad range of supportive services to make life better for families who choose us for their children's care.

Learn More About Riley Support Services

Genetic Home Reference

Genetics Home Reference is a consumer information website by the U.S. National Library of Medicine that provides information about a variety of medical conditions, including abdominal wall defects.

MedlinePlus

Learn more about how an omphalocele develops from this U.S. National Library of Medicine website.

Centers for Disease Control and Prevention

The Centers for Disease Control and Prevention share facts about gastroschisis, including risk factors.

Abdominal Wall Defects Research

Researchers at Riley at IU Health and the Indiana University School of Medicine study effective methods for managing conditions such as gastroschisis, omphalocele and other intestinal conditions.

The Gastroenterology, Hepatology & Nutrition Department at Riley at IU Health participates in medical and nutritional research relating to intestinal failure and short bowel syndrome. Talk to your child’s doctor if you would like to know more about available studies and to learn if your child qualifies for participation in important clinical trials.

Locations

In addition to our primary hospital location at the Academic Health Center in Indianapolis, IN, we have convenient locations to better serve our communities throughout the state.