Omphalocele is a birth defect, visible as:

NHM UP Staff Nurse - 2019

Child Health Nursing (Pediatrics)

Easy

Appeared in: NHM UP Staff Nurse - 2019

Explanation

Omphalocele is a congenital birth defect characterized by a midline opening in the abdominal wall at the point of the umbilicus.
Abdominal organs, such as the intestines and liver, herniate through this opening.
A key feature, visible in the image, is that the herniated organs are enclosed in a translucent, membranous sac made of peritoneum and amnion.

Option A: Swelling of the scrotum is typically indicative of a hydrocele (fluid collection) or an inguinal hernia extending into the scrotum, not an abdominal wall defect at the umbilicus.
Option B: A visible lump in the groin suggests an inguinal hernia, which is a protrusion of tissue through a weak spot in the abdominal muscles of the groin area, not at the navel.
Option C: A fistula between the large intestine and urinary system (colovesical fistula) is an abnormal internal connection and does not present as an external abdominal wall defect.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Definition and clinical presentation of omphalocele as background academic context rather than a clinical decision trigger.
Immediate post-birth nursing care is critical to protect the exposed sac from injury, infection, and fluid loss by covering it with sterile, saline-moistened dressings.
Omphalocele has a high association (up to 70%) with other congenital anomalies, especially cardiac defects and chromosomal abnormalities (e.g., Trisomy 13, 18, Beckwith-Wiedemann syndrome), requiring a thorough neonatal assessment.
What if? If the omphalocele sac ruptures before or during delivery, it becomes a surgical emergency. The priority shifts to preventing infection and managing fluid/heat loss, similar to gastroschisis, by immediately covering the exposed viscera with sterile dressings and preparing for urgent surgery.

How to Approach the Question

Identify the core term in the question: 'Omphalocele'.
Recall or deduce the definition of omphalocele. The prefix 'omphalo-' relates to the umbilicus, and '-cele' refers to a hernia or swelling.
Analyze the provided image, noting the key features: the defect is at the umbilicus (midline) and the organs are contained within a covering sac.
Evaluate each option against this definition and the visual evidence.
Option D directly describes a defect at the umbilicus. Options A and B describe hernias in different locations (scrotum, groin). Option C describes an internal fistula, not an external wall defect.
Conclude that Option D is the only accurate description of an omphalocele.

Concept Tested & Keywords

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E6 Nelson Textbook of Pediatrics(2024) — Volume 1 pp. 1142-1144, 1081-1083