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27. Look at the two pictures below.
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A B
a) Identify the conditions shown.
A: Gastroschisis.
B: Exomphalos.
b) What are the clinical features that distinguish between these two conditions?
1. Exomphalos:
- defect is at the umbilicus.
- herniation of bowel is covered by fuseed amniotic membrane and peritoneum.
2. Gastroschisis:
- defect is 2 - 3cm too the right of the umbilicus.
- the bowel is exposedd.
c) How can these conditions by diagnosed antenatally?
Ultrasound.
1. Exposed bowel is wrapped in a plastic sheet to avoid evaporative heat loss.
2. Send for surgery to return bowel to peritoneal cavity and repair the defect.
e) How would you manage condition B?
1. Place the baby in a warm humidicrib incubator and wrap the entire torso, including the exposed viscera in clear plastic wrap to prevent heat loss.
2. Pass a nasogastric tube to keep the stomach empty.