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Question 11#

The defect in gastroschisis is:

A. To the left of the umbilicus
B. To the right of the umbilicus
C. Through the umbilicus
D. Superior to the umbilicus

Correct Answer is B

Comment:

Gastroschisis represents a congenital anomaly characterized by a defect in the anterior abdominal wall through which the intestinal contents freely protrude. Unlike omphalocele, there is no overlying sac and the size of the defect is usually <4 em. The abdominal wall defect is located at the junction of the umbilicus and normal skin and is almost always to the right of the umbilicus (Fig. below), whereas for omphalocele the umbilical cord inserts into the sac. The umbilicus becomes partly detached, allowing free communication with the abdominal cavity. The appearance of the bowel provides some information with respect to the in utero timing of the defect. The intestine may be normal in appearance, suggesting that the rupture occurred relatively late during the pregnancy. More commonly, however, the intestine is thick, edematous, discolored, and covered with exudate, implying a more longstanding process.

Gastroschisis in a newborn. Note the location of the umbilical cord, and the edematous, thickened bowel.