The Pediatric Surgery service at MassGeneral Hospital for Children is an international referral center for the complete spectrum of general and thoracic pediatric and neonatal surgical services.
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What is an omphalocele?
An omphalocele is a birth defect. It happens when your baby is forming during pregnancy.
In this condition, some of your baby’s abdominal organs poke out (protrude) through an opening in the abdominal muscles. This area is in the umbilical cord. A clear (translucent) membrane covers the organs.
The omphalocele may be small. Only a part of the intestine may stick out. Or it may be large, with most of the abdominal organs being outside the abdomen. These can include the intestine, liver, and spleen.
Your baby’s abdominal cavity may also be too small. This is because it did not fully form in pregnancy.
What causes an omphalocele?
Healthcare providers don't know what causes this condition.
Your baby’s abdominal organs and muscles just don’t form like they should. Many babies born with this condition also have other health issues.
What are the symptoms of an omphalocele?
Your baby’s abdominal organs will poke out through an opening in his or her abdomen.
How is an omphalocele diagnosed?
Your baby’s healthcare provider may spot this issue on an ultrasound in the second or third trimester of pregnancy. Your baby may also need an ultrasound of the heart (fetal echocardiogram) before he or she is born. This test looks for heart problems.
After your baby is born, his or her healthcare provider will see the omphalocele during an exam. Your baby may also need an X-ray. This test is done to look for problems with other organs.
How is an omphalocele treated?
Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.
A small omphalocele
Small omphaloceles are often fixed easily. Your baby will need surgery right after birth. In the surgery, your baby’s organs will be put back into his or her abdomen. The surgeon will also close the opening to your baby’s abdominal wall.
A large omphalocele
If most of your baby’s abdominal organs are affected, he or she will have treatment in stages. Your baby’s treatment may include the following:
- A germ-free (sterile), protective sheet is put over your baby’s abdominal organs.
- Your baby will have surgery. If your baby’s abdomen is small and not fully formed, it may not be able to hold all of your baby’s organs at once. Your baby’s surgeon will slowly put the organs back into the abdomen. This will take several days or weeks.
- Your baby’s surgeon will close the abdominal wall once all of the organs are inside.
Your baby’s abdomen may be small. His or her organs may also be swollen. This can cause your baby to have trouble breathing. Your baby may need a breathing machine (mechanical ventilator). This can help your baby while the swelling goes down and the abdominal cavity grows.
What are the complications of an omphalocele?
If the protective membrane around your baby’s organs breaks, your baby could get an infection. Also, if an organ is pinched or twisted, it can lose its blood supply. This can harm the organ.
Living with an omphalocele
After surgery, your baby may still be at risk for long-term issues. Your baby’s chance for future problems depends on:
- The size of the omphalocele
- If part of the intestine or other organs lost blood flow
- Other health issues
Small omphaloceles normally cause no long-term problems.
Babies with damage to the abdominal organs may have long-term problems. Your child may have trouble with digestion, having bowel movements, and infection.
Ask your child's healthcare provider about your child’s outlook. He or she will make a care plan for your baby. You may need to watch your baby’s nutrition, bowel function, and other aspects of your baby’s health.
When should I call my child's healthcare provider?
You’ll learn how to care for your baby once he or she leaves the hospital. If you have any questions, call your baby’s healthcare provider.
If your child doesn’t gain weight or has trouble eating or having bowel movements, call your child’s healthcare provider.
Key points about an omphalocele
- An omphalocele is a problem your baby is born with. In this condition, some of your baby’s abdominal organs poke out through an opening in the abdominal muscles.
- The omphalocele may be small. Only a part of the intestine may protrude. Or it may be large, with most of the abdominal organs being outside the abdomen. These can include the intestine, liver, and spleen.
- If your baby’s omphalocele is small, he or she will have one surgery to fix it. If your baby’s omphalocele is large, your child’s surgeon will fix it in stages.
- Small omphaloceles are often fixed easily. They normally cause no long-term problems. Babies with damage to the abdominal organs may have long-term problems. Your child may have trouble with digestion, having bowel movements, and infection.
Tips to help you get the most from a visit to your child’s healthcare provider:
- Know the reason for the visit and what you want to happen.
- Before your visit, write down questions you want answered.
- At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
- Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
- Ask if your child’s condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if your child does not take the medicine or have the test or procedure.
- If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
- Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.