When there is herniation of abdominal viscera through open umbilical ring at the site of insertion of umbilical cord, it is known as:

Appeared in: IGNOU PB Bsc Entrance-2022

Explanation

Omphalocele is a congenital defect characterized by the herniation of abdominal contents directly into the base of the umbilical cord.
The key feature described in the question is the location of the defect at the site of the umbilical cord insertion.
Unlike an umbilical hernia, the herniated organs in an omphalocele are covered by a peritoneal sac, not skin.

Option A: This involves herniation of abdominal organs into the chest cavity through a defect in the diaphragm, not the abdominal wall at the umbilicus.
Option B: This is a specific type of diaphragmatic hernia where the stomach protrudes into the chest through the esophageal opening. It is not a defect of the anterior abdominal wall.
Option D: In an umbilical hernia, the protruding contents are covered by intact skin and subcutaneous tissue, not a translucent peritoneal sac. The defect is at the umbilicus but is structurally different.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Congenital abdominal wall defects as background academic context rather than a clinical decision trigger.
Immediate post-delivery care is critical for newborns with omphalocele to protect the exposed sac from rupture, infection, and fluid loss.
Nurses must handle the infant with extreme care, using sterile, warm, saline-soaked dressings and often a sterile bowel bag to maintain temperature and prevent the sac from drying out.
Omphaloceles have a high association with other congenital anomalies (e.g., cardiac defects, Beckwith-Wiedemann syndrome, chromosomal abnormalities), requiring a comprehensive neonatal assessment.

How to Approach the Question

First, analyze the keywords in the question stem: 'herniation of abdominal viscera', 'open umbilical ring', and 'at the site of insertion of umbilical cord'.
These keywords point to a specific type of congenital defect located precisely at the umbilicus and involving the cord itself.
Evaluate the options based on these anatomical landmarks.
Eliminate 'Diaphragmatic hernia' and 'Hiatus hernia' as they involve the diaphragm and chest, not the anterior abdominal wall.
Differentiate between the remaining umbilical defects. The question's description of herniation 'at the site of insertion of umbilical cord' is the classic definition of an omphalocele, where the cord inserts into the herniated sac.
In contrast, an umbilical hernia is a defect in the umbilical ring that is covered by skin. Therefore, select the option that precisely matches the anatomical description provided.

Concept Tested & Keywords

Concept Tested: Congenital abdominal wall defects
Stem keywords: herniation, abdominal viscera, open umbilical ring, insertion of umbilical cord
Lead-in keywords: is known as

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E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 1142-1144

E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed p. 757-759

Practise the full IGNOU PB Bsc Entrance-2022

Attempt every question from this paper in a timed mock, then review the full solution for each one.