Expansion
Omphalocele is covered by a sac and central; gastroschisis is uncovered and to the right
Expansion
| Feature | Omphalocele (exomphalos) | Gastroschisis |
|---|---|---|
| Covering sac | Yes - peritoneum and amnion | No - bowel exposed |
| Position | Central, through the umbilical ring | Right of an intact umbilicus |
| Mechanism | Failure of the physiological hernia to return | Defect in the abdominal wall itself |
| Associated anomalies | Common - cardiac, chromosomal, Beckwith-Wiedemann | Uncommon, usually isolated |
| Bowel condition | Normal, protected | Inflamed, matted from amniotic fluid exposure |
The covering sac is the single most useful discriminator, and it drives management: omphalocele is not immediately threatened and allows time for assessment of associated anomalies, while exposed bowel in gastroschisis needs immediate protection from fluid and heat loss.