Essay Example on Omphalocele: Abdominal Wall Defects & Pathophysiology

Introduction

Omphalocele, in other terms, exomphalos, is a defect acquired during bath: the abdominal (belly) wall is the region in the body that develops defects. The liver, intestines or other organs of the body stick outside of the body via belly button. The body organs protruding outside the body are covered by a thin membrane, which is almost like a transparent sac that is ever broken or opened (Campbell & Copel, 2018). From this assignment, the disease and the pathophysiological aspects will be discussed as well as the clinical signs, treatment, a primary diagnosis, and three interventions associated with the ailment.

Is your time best spent reading someone else’s essay? Get a 100% original essay FROM A CERTIFIED WRITER!

Save 25%

Pathophysiology

In the course of the embryonic period disturbance of organogenesis occurs which leads to omphalocele. Just about the six weeks of development, the contents in the abdomen outgrow in that it cannot be contained any longer in the abdominal cavity and at the last project at the umbilical cord base. Likewise, the event is observed between the 9 and 11 gestation weeks in prenatal ultrasound (Campbell & Copel, 2018). During the physiologic mid-gut herniation the liver is absent. Through the 12 weeks of gestation, the hernia declines, and when it prolongs, it cannot be any more associated with physiological. When the rotation of the contents in the guts fail, Omphalocele transpires and re-emerges to the cavity in the abdomen.

Clinical Manifestation of OmphaloceleThe disease manifests itself in two main forms; small and large omphalocele. Small omphalocele usually is mild compared to large, which has severe consequences for the babies. Infants suffering from the small omphalocele typically get better faster and have little after-effects associated with the condition which contrasts those suffering from large. Mild variations of the illness contain low intestine loops, while severe cases contain the majority of the abdominal organs (Bruch & Langer, 2017). For instance, a baby with large omphalocele may experience retarded growth and development due to the development of related congenital disabilities such as genetic disorders. Most of the patients experience heart disorders that could be corrected through surgery. Apart from the genetic and heart diseases, infants suffering from large omphaloceles may also experience feeding complication and problems with lung development.

Duration, Course, Outcomes and Expectations of OmphaloceleAs the baby is developing in week six to ten during pregnancy, the intestine of the fetus gets long and protrudes out of the body through the umbilical code. However, during the eleventh week of pregnancy, the intestine pushes inside the stomach; conversely, in some instances, the intestine does not push back and hence, it results in a condition known as omphalocele (Bruch & Langer, 2017). Omphalocele can either be large with many organs outside the body or small with few organs protruding outside the body. Since some or all of the organs are outside the body, babies with this condition are prone to develop other complications or medical problems. The abdominal cavity that holds these organs may not grow to its standard size.

Treatment

Omphalocele is treated based on how it manifests itself on the patient. For instance, when the patient is suffering from mild or small omphalocele, then minor surgery can be performed on the patient to ensure that the organs are returned back into the abdomen. However, for the severe cases or large omphalocele, surgery cannot be done on the child as it would stress the baby (Bruch & Langer, 2017). Hence, antibiotic cream is applied on the organs to prevent dehydration of the organs and surgery is done in stages because the baby's abdomen is still underdeveloped and would pose a challenge if all the organs were to be placed back in the abdomen all at once. During the transfer of patients suffering from the condition, covering the internal organs with a semi-permeable non-adherent membrane prevents dehydration of the organs.

Nursing Diagnosis

The condition can best be diagnosed by ultrasound that offers a visible assessment of the developing fetus' anatomy, the mother's womb, as well as the flow of blood. Another test performed is the fetal magnetic resonance imaging (MRI) used together with the ultrasound to collect additional images, that are more focused, of the developing fetus. Another critical test that is conducted during the diagnosis is a fetal echocardiogram which is an ultrasound that evaluates the operation of the fetus heart. A karyotype is also undertaken to establish the potential genetic basis through the assessment of the chromosome. Lastly, there is a screening of the serum as well as blood (Baerg & Munoz, 2019). All these tests are performed on the fetus to establish the best treatment for the baby when it is born.

Clinical Intervention

After the patient is diagnosed with the condition, the neurologic, heart, skin, lungs, and genitourinary system are examined to ensure there are no accompanying congenital defects. Prevention of fluids is achieved through covering the sac with plastic bowel bag and sterile gauze soaked in saline (Campbell & Copel, 2018). Assessment of the appearance of the condition such as color and twisting of the intestines as well as assessment of the vitals like temperature to note signs of fever or hypothermia.

References

Baerg, J. E., & Munoz, A. N. (2019, April). Long term complications and outcomes in omphalocele. In Seminars in pediatric surgery (Vol. 28, No. 2, pp. 118-121). WB Saunders.

Bruch, S. W., & Langer, J. C. (2017). Omphalocele and gastroschisis. In Newborn surgery (pp. 781-790). CRC Press.

Campbell, K. H., & Copel, J. A. (2018). Omphalocele. In Obstetric Imaging: Fetal Diagnosis and Care (pp. 84-91). Elsevier.