Omphalocele is persistent herniation of bowel into the umbilicus. A sac of peritoneum and amnion covers the bowel, with the normal umbilicus at the apex of the sac. The sac may vary in size, and be small as shown here.
Omphalocele (medium size shown here) is more common with older mothers, and is usually diagnosed by fetal ultrasound. The abdominal cavity is correspondingly small, in inverse proportion to the herniated bowel mass.
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A giant omphalocele, as shown here, may be too large to be reduced in the short term, and may need to be skin grafted and staged as in this case. In 25% of cases, the liver is also found partially in the sac.
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