20 QUESTIONS AND ANSWERS
About
1. What is a omfalokel?
Answer:
Omphalokel a language derived from Greek omphalos, which means the cord and umbilicus = Cele which means the form of hernia. Omphalokel interpreted as a central defect of the abdominal wall at the ring area umbilicus (umbilical ring) or ring the umbilical cord so that there is herniation of abdominal internal organs of the abdominal cavum but still dilapiasi by a bag or membrane. Omphalocele can also be interpreted as a clear bag no blood vascular layer composed of peritoneum and amnion layer at the base of the umbilical cord.
So, omfalokel is protrusion of the intestine or other abdominal contents through the root of the navel which is only covered by peritoneum (the lining of the stomach) and not covered by skin.
2. How omfelokel etiology?
Answer:
The exact cause of omphalokel unclear until now. Some risk factors or contributing factors causing the occurrence omphalokel include infection, drug use and smoking in pregnant women, folic acid deficiency, hypoxia, use of salicylates, genetic abnormalities and polihidramnion.
In 25-40% of infants who suffer omfalokel, this disorder is accompanied by other congenital abnormalities, such as chromosomal abnormalities, diaphragmatic hernia and cardiac abnormalities.
3. whether symptoms omfelokel?
Answer:
Number of intestines and other abdominal organs protruding on omfalokel vary, depending on the size of the hole in the navel.
If the hole small, perhaps only the protruding bowel, but if the big holes, the liver can also be protruding through the hole.
4. how is that happening omfalokel Embryogenesis trip?
Answer:
At the fetal age of 5-6 weeks of abdominal contents lie outside the embryo in the coelomic cavity. At the age of 10 weeks of development occurs from the intestinal lumen so that extra abdominal peritoneum akanmasuk into the abdominal cavity. When this process is inhibited there will be a bag at the base of the umbilicus that contains the intestines, stomach sometimes liver. The walls consist of layers of thin layers of peritoneum and amnion are both nodes so that the bag was visible from the outside, a condition termed omfalokel.
5. how do the treatment on omfalokel?
Answer:
a. NG tube pairs untu reduce air pressure
b. IV fluids
c. prophylactic antibiotics (prophylactic)
d. back operation of damaged stomach didnding
6. How do I treat minor damage (<2cm)?
Answer:
By way of closing the abdominal wall
7. how how to treat damage to the secondary level (20-10 cm)?
replied:
by moving the outer lining of dams placed pieces of silicon to form a “silo”, a temporary place for the contents of the abdomen, then slowly pewrlahan silo size will decrease / decreases and no more than four to seven days abdominal loading / accommodate the viscera (the contents ringga peurt ) then the damage will be covered.
8. memgobati how do great damage (> 10 cm)?
replied:
with leather cover or treat with spray batadin, mercurochrome, or silver sulfadiazine (silvadine) around the damage. Let the scar is formed, with epitelisasi continuously, provide an opportunity to correct scar tissue from the first month until the following year.
9. What abnormalities associated with omfalokel?
Answer:
50% of the cases that often occurs is the presence of abnormal cardiovascular system, gastrointestinal, urinary genita, musculoskeletal system, and chromosomal persyarafan system.
10. whether the organs that are often found protruding on omfalokel but almost never found in gastroschisis?
Answer:
Liver (Liver)
11. What are the possible existence of the complications in omfalokel?
Answer:
· Error rotation occurs in the intestines or penympangan.
· Early complications are infection in the pouch that easily occurs on the bare surface. Kongenitak abnormalities of the abdominal wall may be accompanied by congenital abnormalities that worsen the prognosis
12. Palliative Medicine at how do omfalokel?
replied:
Pocket size, extent of abdominal wall defects and whether the liver in the bag will determine the way of treatment. When a small omfalokel bag, can be performed one stage operation. Walls removed the bag, the bag is inserted into the abdominal cavity, then the hole is closed with the peritoneum, fascia and skin. But omfalokel usually too big and too small abdominal cavity so that the bag can not be inserted into the abdominal cavity. If forced then strain the abdominal wall because the diaphragm upward driven respiratory symptoms occur. The inferior vena cava obstruction can also occur because of the emphasis.
Actions that can be done is to protect the bag with a liquid anti-septic omfalokel example betadin and closed it with a cloth so as not contaminated dakron. Thus there is a chance occurrence epitelisasi from the edge so that the entire closed pouch epithelium and formed a large hernia ventralis. Epitelisasi takes 3-4 months. Then
13. what is the frequency of occurrence omfalokel?
Answer:
Omfalokel occurs in 1 in 5000 births.
Visible from outside through the intestinal lining of the peritoneum is a thin and transparent (opaque).
14. consists of what are the coatings of omfalokel?
Answer:
Membrane consists of layers of amnion and peritoneum.
15. Which in part pentologi omfalokel it?
Answer:
Cantrell section pentologi
16. Cantrell apah pentologi it?
Answer:
· Damage to the diaphragm (hernia)
· Abnormalities in cardiac (heart)]
· Pericardium defect
· Damage to the sternum
17. terladinya omfalokel how early?
Answer:
Omphalokel onset is still unclear and there are several theories explaining the possible development of embryology omphalokel. The theory is mentioned by many experts is that omphalokel developed because of the failure of embryonic migration and fusion of the cranial folds, caudal and lateral to the umbilicus when forming a ring on the center line before the invasion of myotomes at week 4 of development. Another theory states that develop due to failure of midgut omphalokel to get back into the abdominal cavity at week 12 of development.
18. bagaimanakh history about omfalokel?
Answer:
Omphalokel was first described by a French surgeon named Ambroise Pare in 1634. He describes omphalokel accurately and perform management of a conservative form of free agents on the surface membrane eskarotik omphalokel uintuk stimulate epitelisasi. Management approach is then poses several problems such as requiring a long time, so membutukan also nutritional and metabolic aspects. Rupture of membranes can also cause the infection.
Only later in the year 1948, Robet Gross in Boston introduced a method of closing a large and successful omphalokel. He described the closure omphalokele through two stages. The first stage is to create a skin flap to protect the abdominal organs are experiencing herniation. The second stage is to repair the hernia ventralis.
Schuster in 1967 and then introduce the use of prosthetic material to protect the abdominal organs during the first stage. Finally in 1969, Allen and Wrenn memeperkenalkan on a technique of “Shiloh”, where the abdominal organs are experiencing herniation silastic covered with a layer that is attached to the fascia of the abdominal wall. Abdominal organs are then inserted in the abdominal cavity through bartahap into progessiv tightening / pressure manually in a few days. Since penenemuan was primarily omphalokel defect closure is possible in the early days of the baby. Until now, various attempts were made to obtain satisfactory clinical results.
19. How do I diagnose omfalokel?
Answer:
° before childbirth U / S
· The diagnosis is based on the results of physical examination, in which stomach contents visible from the outside through the lining of the peritoneum.
20. PATOFISIOLOGIS?
Answer:
Congenital abnormalities and Gastrischisis Omfalokel
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