Omphalocele and gastroschisis !
- Malformation
Two abdominal wall defects with bowel outside: omphalocele sits at the navel and is covered; gastroschisis sits beside it and is bare.
Updated 2026-11-01
See it in 3D: Linea alba · Rectus abdominis
What it is
Omphalocele is persistence of viscera outside the abdomen at the base of the umbilical cord, covered by a membrane of amnion and peritoneum, because the herniated loop does not return to the cavity. Gastroschisis is a wall defect beside the umbilicus, almost always on the right, through which the bowel protrudes with no covering and floats in the amniotic fluid. They are told apart by the membrane, the location and, above all, the associated malformations.
Embryological cause
- Omphalocele: the bowel that entered the cord during physiological herniation (week 6) does not return to the abdomen by weeks 10 to 12.
- So the sac has the coverings of the cord: amnion outside and peritoneum inside; it may contain liver.
- Gastroschisis: a closure defect of the ventral abdominal wall, usually to the right of the umbilicus; its exact cause is debated (failed lateral folding or a local vascular injury).
- In gastroschisis the cord inserts normally and there is no sac: the bowel floats free in the amniotic fluid.
Omphalocele versus gastroschisis
| Feature | Omphalocele | Gastroschisis |
|---|---|---|
| Location | Midline, at the base of the cord | Beside the umbilicus, almost always right |
| Covering | Sac of amnion and peritoneum | None: bowel exposed |
| Contents | Bowel and often liver | Mostly bowel |
| Cord | Arises from the sac | Normal, beside the defect |
| Associated anomalies | Common: trisomies, heart defects, Beckwith-Wiedemann | Rare; sometimes intestinal atresia |
| Mother | Age extremes | Very young; tobacco, alcohol |
| Outlook | Depends on associated anomalies | Generally good if isolated |
How it presents
- Omphalocele: a mass at the base of the cord covered by a thin, almost transparent membrane; if the sac ruptures, infection risk rises.
- Omphalocele: associated with trisomies 13 and 18, heart defects, pentalogy of Cantrell and Beckwith-Wiedemann syndrome (macroglossia, macrosomia, hypoglycaemia).
- Gastroschisis: free, thickened, fibrin-coated bowel loops beside a normal cord.
- Gastroschisis: heat and fluid loss through the exposed bowel; there may be atresia, ischaemia or short bowel.
- Both have intestinal malrotation, because rotation is never completed.
- An umbilical hernia, by contrast, is covered by skin and usually closes on its own.
Diagnosis
- Prenatal ultrasound: omphalocele is recognised once physiological herniation is over, after week 12; gastroschisis shows free loops floating beside the cord.
- Raised maternal serum alpha-fetoprotein, higher in gastroschisis.
- In omphalocele: karyotype and fetal echocardiogram.
Test yourself
Think of the answer, then tap the question to see it.
What tells omphalocele from gastroschisis at a glance?
Omphalocele sits at the base of the cord and is covered by a sac; gastroschisis sits beside the umbilicus, almost always on the right, with no sac.
Which of the two is more often associated with trisomies and heart defects?
Omphalocele; gastroschisis is usually isolated, though it may come with intestinal atresia.
Why can omphalocele not be diagnosed before week 12?
Because until then the bowel is normally herniated into the cord (physiological herniation).
Which overgrowth syndrome is associated with omphalocele?
Beckwith-Wiedemann syndrome, with macroglossia, macrosomia and neonatal hypoglycaemia.
See it in 3D
The structures of Durgical's 3D anatomy where it is found.
Related
- Midgut: physiological herniation and rotation
- Embryonic folding: head, tail and lateral folds
- Umbilical cord: two arteries, one vein
- Malrotation and midgut volvulus
- Jejunal and ileal atresia
- Prenatal diagnosis: ultrasound, serum screening, cell-free DNA, CVS, amniocentesis
- Bladder exstrophy
Related conditions
Educational content on embryonic development; not a guide to prenatal diagnosis or to medicines in pregnancy and no substitute for a health professional's advice. No doses are given.
Sources: Omphalocele (StatPearls Publishing (NCBI Bookshelf), 2026); Gastroschisis (Centers for Disease Control and Prevention (CDC), 2026); Omphalocele (Centers for Disease Control and Prevention (CDC), 2026).
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Representative model, for educational purposes only.