Portal de Periódicos da CAPES

Anterior abdominal wall defects

1991; Elsevier BV; Volume: 1; Issue: 3 Linguagem: Inglês

10.1016/0957-5847(91)90064-5

1532-205X

P.A.M. Raine,

Congenital Diaphragmatic Hernia Studies

Defects in the anterior abdominal wall or ‘belly-clefts’ have been a recognised congenital malformation for many centuries but only relatively recently has clear differentiation been made. For practical purposes, they are classifiable into body stalk anomaly, exomphalos (or omphalocele), hernia into the cord or gastroschisis. A body stalk anomaly is mainly of pathological interest as it is a major malformation of abdominal wall, pelvis and lower limbs incompatible with fetal survival. Exomphalos was first specifically described by Ambroise Pare’ and is a defect of varying size occurring at the umbilical ring through which small bowel, large bowel and liver protrude outside the abdominal cavity covered by a membrane with the umbilical cord at its apex; severe forms show epigastric and hypogastric abdominal wall deficiency and major associated abnormalities. Hernia into the cord is a very minor variety of exomphalos with an almost normal umbilical ring but a distended umbilical cord containing a peritoneal hernial sac enclosing bowel. Gastroschisis was well-defined as a separate entity only in 1953’ and is a defect almost invariably to the right of a normal umbilical cord insertion through which a varying amount of intestine, though not liver, prolapses without protection of a membrane. Despite increasing knowledge, in part obtained by in utero ultrasound studies, debate continues to surround precise definitions of these abnormalities and, of necessity, has involved complex embryological arguments.