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Omphalocele and gastroschisis are congenital abdominal wall defects that result in herniation of abdominal contents outside the body cavity. Omphalocele involves herniation through the umbilical ring with organs covered by a peritoneal sac, while gastroschisis is a full-thickness defect lateral to the umbilicus with uncovered bowel loops exposed to amniotic fluid.
Omphalocele results from failure of the intestinal loops to return to the abdominal cavity during the 10th week of gestation, with persistence of the physiological umbilical hernia covered by Wharton's jelly and peritoneum. Gastroschisis occurs due to a vascular accident or failure of mesenchymal proliferation leading to a full-thickness abdominal wall defect, typically to the right of the umbilicus, without a covering sac.
Omphalocele is often associated with other congenital anomalies and chromosomal abnormalities, requiring comprehensive evaluation and potentially staged surgical repair depending on the size of the defect. Gastroschisis typically occurs as an isolated anomaly with exposed bowel requiring immediate surgical intervention to prevent complications from prolonged exposure, dehydration, and bowel inflammation.