Fung-Yen Lim

180 timestamped statements across 5 collections — auto-found in recorded discussions, each timestamp jumps to the exact moment.

Featured diaries

▶ Ep 25 · 5:34
If you have a bowel that look pretty pristine, non-thickened, non-inflammatory, only small amount of them being on the outside and that's enough abdominal domain, you can actually push them all back very quickly and perform primary closure
quote · Abdominal Wall Defects
▶ Ep 37 · 5:34
If you have a bowel that look pretty pristine, non-thickened, non-inflammatory, only small amount of them being on the outside and that's enough abdominal domain, you can actually push them all back very quickly and perform primary closure
quote · Etiologies (Gastroschisis/NEC/Atresia/Volvulus)
▶ Ep 15 · 5:34
If you have a bowel that look pretty pristine, non-thickened, non-inflammatory, only small amount of them being on the outside and that's enough abdominal domain, you can actually push them all back very quickly and perform primary closure
quote · Gastroschisis
▶ Ep 50 · 5:34
If you have a bowel that look pretty pristine, non-thickened, non-inflammatory, only small amount of them being on the outside and that's enough abdominal domain, you can actually push them all back very quickly and perform primary closure
quote · Intestinal Rehab
▶ Ep 8 · 5:34
If you have a bowel that look pretty pristine, non-thickened, non-inflammatory, only small amount of them being on the outside and that's enough abdominal domain, you can actually push them all back very quickly and perform primary closure
quote · Omphalocele
▶ Ep 25 · 6:58
After you push the bowel back in, uh, you don't take these babies to the operating room to close that with suture, but rather put the umbilical cord over and then the dressing over. And a lot of times skin will grow over
quote · Abdominal Wall Defects

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Abdominal Wall Defects 36 entries

Omphalocele and Gastroschisis With Dr. Foong-Yen Lim

▶ Ep 25 · 0:55
clinical Gastroschisis is a full thickness abdominal wall defect just to the right of the umbilicus, in which peritoneal contents, most often intestines, protrude through the abdomen without any membranous cover. ↗
▶ Ep 25 · 0:55
clinical Omphalocele is a congenital disorder and can have associated anomalies, but gastroschisis occurs in otherwise normal babies that have an intrauterine event during development. ↗
▶ Ep 25 · 0:55
clinical Omphalocele is right through the middle of the umbilicus and has a membranous cover. ↗
▶ Ep 25 · 0:55
quote umbilical is a congenital disorder and can have associated anomalies, but gastroschisis occurs in otherwise normal babies that have an intrauterine event during development ↗
▶ Ep 25 · 0:55
quote gastroschisis is a full thickness abdominal wall defect just to the right of the umbilicus, in which peritoneal contents, most often intestines, protrude through the abdomen without any membranous cover ↗
▶ Ep 25 · 1:54
clinical For gastroschisis, only ultrasound confirmed diagnosis is obtained without additional imaging. ↗
▶ Ep 25 · 1:54
clinical For omphalocele, besides ultrasound, MRI and echocardiogram are routinely obtained because these patients may have other associated anomalies. ↗
▶ Ep 25 · 1:54
clinical Fetal growth is tracked monthly in gastroschisis and omphalocele cases because there is concern for significant growth restriction. ↗
▶ Ep 25 · 1:54
quote If you see a very high level of alpha fetal protein, think about um, gastroschisis or emphalaceal ↗
▶ Ep 25 · 1:54
clinical Very high level of alpha fetal protein is associated with gastroschisis or omphalocele. ↗
▶ Ep 25 · 1:54
clinical Alpha fetal protein (AFP) is a screening test, but ultrasound imaging is needed to definitively diagnose abdominal wall defects. ↗
▶ Ep 25 · 2:56
quote Inutero growth restriction, as well as IUFD in utero fetal demise, uh, can occur in this patient ↗
▶ Ep 25 · 2:56
clinical Biophysical profile and non-stress testing are needed because intrauterine growth restriction and intrauterine fetal demise (IUFD) can occur in these patients. ↗
▶ Ep 25 · 2:56
clinical If surveillance imaging becomes worrisome enough regarding intrauterine fetal demise, the mother and fetus need to be admitted for continuous monitoring or emergent delivery. ↗
▶ Ep 25 · 3:27
quote It's, uh, most common among babies born to young mother of low gravity and usually first pregnancy. And 75% of that is the first born ↗
▶ Ep 25 · 3:27
epidemiological Other risk factors for gastroschisis include acetaminophen, vitamin B deficiencies, drug use, and some genetic predispositions. ↗
▶ Ep 25 · 3:27
epidemiological Pseudoephedrine has an odds ratio of 4.2 times for gastroschisis compared to aspirin alone at 2.7. ↗
▶ Ep 25 · 3:27
epidemiological More than 90% of gastroschisis infants are born less than 2,500 grams in weight due to intrauterine growth restriction. ↗
▶ Ep 25 · 3:27
epidemiological Gastroschisis is most common among babies born to young mothers of low gravidity, usually first pregnancy, with 75% being first born and 25% in second or subsequent pregnancies. ↗
▶ Ep 25 · 3:27
quote more than 90% of these infants born less than 2,500 grams in weight ↗
▶ Ep 25 · 3:27
epidemiological Nearly 60% of gastroschisis cases are premature. ↗
▶ Ep 25 · 4:19
epidemiological Mothers with omphalocele are usually advanced in age compared to the gastroschisis group, with advanced maternal age having an odds ratio of 3.3. ↗
▶ Ep 25 · 4:19
epidemiological Major risk factors for omphalocele are trisomy 13, 18, and 21, which occur in anywhere between 35 and 90% of patients with omphalocele. ↗
▶ Ep 25 · 5:02
clinical These babies can have significant acidosis and pulmonary hypertension. ↗
▶ Ep 25 · 5:02
clinical Crucial immediate postnatal procedures include minimizing heat loss and fluid loss, otherwise babies can show up extremely dehydrated and cold. ↗
▶ Ep 25 · 5:02
quote Minimizing heat loss and fluid loss in these babies. Otherwise they can show up, uh, extremely dehydrated as well as, um, being cold ↗
▶ Ep 25 · 5:34
clinical Primary closure is considered if the bowel looks pristine, non-thickened, non-inflammatory, with only small amount outside and enough abdominal domain to push them all back very quickly. ↗
▶ Ep 25 · 5:34
quote If you have a bowel that look pretty pristine, non-thickened, non-inflammatory, only small amount of them being on the outside and that's enough abdominal domain, you can actually push them all back very quickly and perform primary closure ↗
▶ Ep 25 · 6:07
quote We favor stage closure if the defect is large or, um, there's issue with the bowel ↗
▶ Ep 25 · 6:07
clinical Staged closure is favored if the defect is large or there are issues with the bowel, including atresia, compromised bowel, or perforation. ↗
▶ Ep 25 · 6:07
clinical Some patients develop intestinal perforation after only two to four days of enteral feeding. ↗
▶ Ep 25 · 6:58
clinical In sutureless closure, after pushing the bowel back in, babies are not taken to the operating room for suture closure; instead, the umbilical cord is placed over with dressing, and skin will grow over, although a small umbilical defect may remain that can close spontaneously over time. ↗
▶ Ep 25 · 6:58
quote After you push the bowel back in, uh, you don't take these babies to the operating room to close that with suture, but rather put the umbilical cord over and then the dressing over. And a lot of times skin will grow over ↗
▶ Ep 25 · 7:29
clinical For small bowel atresia encountered during closure, management options include tapering the dilated portion of bowel or resecting the bowel before tapering. ↗
▶ Ep 25 · 7:57
clinical For omphalocele with no significant respiratory issues, sequential reduction using meshes is the best option, sewing meshes to the edges of the fascia without interrupting the membrane. ↗
▶ Ep 25 · 8:43
clinical After sequential reduction with plastic clips, the patient is taken to the operating room for delayed primary closure of the fascia and skin. ↗
Etiologies (Gastroschisis/NEC/Atresia/Volvulus) 36 entries

Omphalocele and Gastroschisis With Dr. Foong-Yen Lim

▶ Ep 37 · 0:55
quote umbilical is a congenital disorder and can have associated anomalies, but gastroschisis occurs in otherwise normal babies that have an intrauterine event during development ↗
▶ Ep 37 · 0:55
quote gastroschisis is a full thickness abdominal wall defect just to the right of the umbilicus, in which peritoneal contents, most often intestines, protrude through the abdomen without any membranous cover ↗
▶ Ep 37 · 0:55
clinical Gastroschisis is a full thickness abdominal wall defect just to the right of the umbilicus, in which peritoneal contents, most often intestines, protrude through the abdomen without any membranous cover. ↗
▶ Ep 37 · 0:55
clinical Omphalocele is right through the middle of the umbilicus and has a membranous cover. ↗
▶ Ep 37 · 0:55
clinical Omphalocele is a congenital disorder and can have associated anomalies, but gastroschisis occurs in otherwise normal babies that have an intrauterine event during development. ↗
▶ Ep 37 · 1:54
clinical For omphalocele, besides ultrasound, MRI and echocardiogram are routinely obtained because these patients may have other associated anomalies. ↗
▶ Ep 37 · 1:54
clinical Fetal growth is tracked monthly in gastroschisis and omphalocele cases because there is concern for significant growth restriction. ↗
▶ Ep 37 · 1:54
quote If you see a very high level of alpha fetal protein, think about um, gastroschisis or emphalaceal ↗
▶ Ep 37 · 1:54
clinical Very high level of alpha fetal protein is associated with gastroschisis or omphalocele. ↗
▶ Ep 37 · 1:54
clinical Alpha fetal protein (AFP) is a screening test, but ultrasound imaging is needed to definitively diagnose abdominal wall defects. ↗
▶ Ep 37 · 1:54
clinical For gastroschisis, only ultrasound confirmed diagnosis is obtained without additional imaging. ↗
▶ Ep 37 · 2:56
clinical Biophysical profile and non-stress testing are needed because intrauterine growth restriction and intrauterine fetal demise (IUFD) can occur in these patients. ↗
▶ Ep 37 · 2:56
quote Inutero growth restriction, as well as IUFD in utero fetal demise, uh, can occur in this patient ↗
▶ Ep 37 · 2:56
clinical If surveillance imaging becomes worrisome enough regarding intrauterine fetal demise, the mother and fetus need to be admitted for continuous monitoring or emergent delivery. ↗
▶ Ep 37 · 3:27
quote more than 90% of these infants born less than 2,500 grams in weight ↗
▶ Ep 37 · 3:27
epidemiological Gastroschisis is most common among babies born to young mothers of low gravidity, usually first pregnancy, with 75% being first born and 25% in second or subsequent pregnancies. ↗
▶ Ep 37 · 3:27
epidemiological Nearly 60% of gastroschisis cases are premature. ↗
▶ Ep 37 · 3:27
epidemiological More than 90% of gastroschisis infants are born less than 2,500 grams in weight due to intrauterine growth restriction. ↗
▶ Ep 37 · 3:27
epidemiological Pseudoephedrine has an odds ratio of 4.2 times for gastroschisis compared to aspirin alone at 2.7. ↗
▶ Ep 37 · 3:27
epidemiological Other risk factors for gastroschisis include acetaminophen, vitamin B deficiencies, drug use, and some genetic predispositions. ↗
▶ Ep 37 · 3:27
quote It's, uh, most common among babies born to young mother of low gravity and usually first pregnancy. And 75% of that is the first born ↗
▶ Ep 37 · 4:19
epidemiological Major risk factors for omphalocele are trisomy 13, 18, and 21, which occur in anywhere between 35 and 90% of patients with omphalocele. ↗
▶ Ep 37 · 4:19
epidemiological Mothers with omphalocele are usually advanced in age compared to the gastroschisis group, with advanced maternal age having an odds ratio of 3.3. ↗
▶ Ep 37 · 5:02
clinical These babies can have significant acidosis and pulmonary hypertension. ↗
▶ Ep 37 · 5:02
quote Minimizing heat loss and fluid loss in these babies. Otherwise they can show up, uh, extremely dehydrated as well as, um, being cold ↗
▶ Ep 37 · 5:02
clinical Crucial immediate postnatal procedures include minimizing heat loss and fluid loss, otherwise babies can show up extremely dehydrated and cold. ↗
▶ Ep 37 · 5:34
quote If you have a bowel that look pretty pristine, non-thickened, non-inflammatory, only small amount of them being on the outside and that's enough abdominal domain, you can actually push them all back very quickly and perform primary closure ↗
▶ Ep 37 · 5:34
clinical Primary closure is considered if the bowel looks pristine, non-thickened, non-inflammatory, with only small amount outside and enough abdominal domain to push them all back very quickly. ↗
▶ Ep 37 · 6:07
clinical Some patients develop intestinal perforation after only two to four days of enteral feeding. ↗
▶ Ep 37 · 6:07
quote We favor stage closure if the defect is large or, um, there's issue with the bowel ↗
▶ Ep 37 · 6:07
clinical Staged closure is favored if the defect is large or there are issues with the bowel, including atresia, compromised bowel, or perforation. ↗
▶ Ep 37 · 6:58
clinical In sutureless closure, after pushing the bowel back in, babies are not taken to the operating room for suture closure; instead, the umbilical cord is placed over with dressing, and skin will grow over, although a small umbilical defect may remain that can close spontaneously over time. ↗
▶ Ep 37 · 6:58
quote After you push the bowel back in, uh, you don't take these babies to the operating room to close that with suture, but rather put the umbilical cord over and then the dressing over. And a lot of times skin will grow over ↗
▶ Ep 37 · 7:29
clinical For small bowel atresia encountered during closure, management options include tapering the dilated portion of bowel or resecting the bowel before tapering. ↗
▶ Ep 37 · 7:57
clinical For omphalocele with no significant respiratory issues, sequential reduction using meshes is the best option, sewing meshes to the edges of the fascia without interrupting the membrane. ↗
▶ Ep 37 · 8:43
clinical After sequential reduction with plastic clips, the patient is taken to the operating room for delayed primary closure of the fascia and skin. ↗
Gastroschisis 36 entries

Omphalocele and Gastroschisis With Dr. Foong-Yen Lim

▶ Ep 15 · 0:55
clinical Gastroschisis is a full thickness abdominal wall defect just to the right of the umbilicus, in which peritoneal contents, most often intestines, protrude through the abdomen without any membranous cover. ↗
▶ Ep 15 · 0:55
quote umbilical is a congenital disorder and can have associated anomalies, but gastroschisis occurs in otherwise normal babies that have an intrauterine event during development ↗
▶ Ep 15 · 0:55
clinical Omphalocele is right through the middle of the umbilicus and has a membranous cover. ↗
▶ Ep 15 · 0:55
clinical Omphalocele is a congenital disorder and can have associated anomalies, but gastroschisis occurs in otherwise normal babies that have an intrauterine event during development. ↗
▶ Ep 15 · 0:55
quote gastroschisis is a full thickness abdominal wall defect just to the right of the umbilicus, in which peritoneal contents, most often intestines, protrude through the abdomen without any membranous cover ↗
▶ Ep 15 · 1:54
clinical For omphalocele, besides ultrasound, MRI and echocardiogram are routinely obtained because these patients may have other associated anomalies. ↗
▶ Ep 15 · 1:54
clinical Alpha fetal protein (AFP) is a screening test, but ultrasound imaging is needed to definitively diagnose abdominal wall defects. ↗
▶ Ep 15 · 1:54
clinical For gastroschisis, only ultrasound confirmed diagnosis is obtained without additional imaging. ↗
▶ Ep 15 · 1:54
clinical Very high level of alpha fetal protein is associated with gastroschisis or omphalocele. ↗
▶ Ep 15 · 1:54
clinical Fetal growth is tracked monthly in gastroschisis and omphalocele cases because there is concern for significant growth restriction. ↗
▶ Ep 15 · 1:54
quote If you see a very high level of alpha fetal protein, think about um, gastroschisis or emphalaceal ↗
▶ Ep 15 · 2:56
quote Inutero growth restriction, as well as IUFD in utero fetal demise, uh, can occur in this patient ↗
▶ Ep 15 · 2:56
clinical If surveillance imaging becomes worrisome enough regarding intrauterine fetal demise, the mother and fetus need to be admitted for continuous monitoring or emergent delivery. ↗
▶ Ep 15 · 2:56
clinical Biophysical profile and non-stress testing are needed because intrauterine growth restriction and intrauterine fetal demise (IUFD) can occur in these patients. ↗
▶ Ep 15 · 3:27
quote It's, uh, most common among babies born to young mother of low gravity and usually first pregnancy. And 75% of that is the first born ↗
▶ Ep 15 · 3:27
epidemiological Gastroschisis is most common among babies born to young mothers of low gravidity, usually first pregnancy, with 75% being first born and 25% in second or subsequent pregnancies. ↗
▶ Ep 15 · 3:27
epidemiological Nearly 60% of gastroschisis cases are premature. ↗
▶ Ep 15 · 3:27
epidemiological More than 90% of gastroschisis infants are born less than 2,500 grams in weight due to intrauterine growth restriction. ↗
▶ Ep 15 · 3:27
epidemiological Pseudoephedrine has an odds ratio of 4.2 times for gastroschisis compared to aspirin alone at 2.7. ↗
▶ Ep 15 · 3:27
epidemiological Other risk factors for gastroschisis include acetaminophen, vitamin B deficiencies, drug use, and some genetic predispositions. ↗
▶ Ep 15 · 3:27
quote more than 90% of these infants born less than 2,500 grams in weight ↗
▶ Ep 15 · 4:19
epidemiological Major risk factors for omphalocele are trisomy 13, 18, and 21, which occur in anywhere between 35 and 90% of patients with omphalocele. ↗
▶ Ep 15 · 4:19
epidemiological Mothers with omphalocele are usually advanced in age compared to the gastroschisis group, with advanced maternal age having an odds ratio of 3.3. ↗
▶ Ep 15 · 5:02
clinical Crucial immediate postnatal procedures include minimizing heat loss and fluid loss, otherwise babies can show up extremely dehydrated and cold. ↗
▶ Ep 15 · 5:02
quote Minimizing heat loss and fluid loss in these babies. Otherwise they can show up, uh, extremely dehydrated as well as, um, being cold ↗
▶ Ep 15 · 5:02
clinical These babies can have significant acidosis and pulmonary hypertension. ↗
▶ Ep 15 · 5:34
clinical Primary closure is considered if the bowel looks pristine, non-thickened, non-inflammatory, with only small amount outside and enough abdominal domain to push them all back very quickly. ↗
▶ Ep 15 · 5:34
quote If you have a bowel that look pretty pristine, non-thickened, non-inflammatory, only small amount of them being on the outside and that's enough abdominal domain, you can actually push them all back very quickly and perform primary closure ↗
▶ Ep 15 · 6:07
clinical Staged closure is favored if the defect is large or there are issues with the bowel, including atresia, compromised bowel, or perforation. ↗
▶ Ep 15 · 6:07
clinical Some patients develop intestinal perforation after only two to four days of enteral feeding. ↗
▶ Ep 15 · 6:07
quote We favor stage closure if the defect is large or, um, there's issue with the bowel ↗
▶ Ep 15 · 6:58
quote After you push the bowel back in, uh, you don't take these babies to the operating room to close that with suture, but rather put the umbilical cord over and then the dressing over. And a lot of times skin will grow over ↗
▶ Ep 15 · 6:58
clinical In sutureless closure, after pushing the bowel back in, babies are not taken to the operating room for suture closure; instead, the umbilical cord is placed over with dressing, and skin will grow over, although a small umbilical defect may remain that can close spontaneously over time. ↗
▶ Ep 15 · 7:29
clinical For small bowel atresia encountered during closure, management options include tapering the dilated portion of bowel or resecting the bowel before tapering. ↗
▶ Ep 15 · 7:57
clinical For omphalocele with no significant respiratory issues, sequential reduction using meshes is the best option, sewing meshes to the edges of the fascia without interrupting the membrane. ↗
▶ Ep 15 · 8:43
clinical After sequential reduction with plastic clips, the patient is taken to the operating room for delayed primary closure of the fascia and skin. ↗
Intestinal Rehab 36 entries

Omphalocele and Gastroschisis With Dr. Foong-Yen Lim

▶ Ep 50 · 0:55
clinical Omphalocele is right through the middle of the umbilicus and has a membranous cover. ↗
▶ Ep 50 · 0:55
quote umbilical is a congenital disorder and can have associated anomalies, but gastroschisis occurs in otherwise normal babies that have an intrauterine event during development ↗
▶ Ep 50 · 0:55
quote gastroschisis is a full thickness abdominal wall defect just to the right of the umbilicus, in which peritoneal contents, most often intestines, protrude through the abdomen without any membranous cover ↗
▶ Ep 50 · 0:55
clinical Omphalocele is a congenital disorder and can have associated anomalies, but gastroschisis occurs in otherwise normal babies that have an intrauterine event during development. ↗
▶ Ep 50 · 0:55
clinical Gastroschisis is a full thickness abdominal wall defect just to the right of the umbilicus, in which peritoneal contents, most often intestines, protrude through the abdomen without any membranous cover. ↗
▶ Ep 50 · 1:54
quote If you see a very high level of alpha fetal protein, think about um, gastroschisis or emphalaceal ↗
▶ Ep 50 · 1:54
clinical Very high level of alpha fetal protein is associated with gastroschisis or omphalocele. ↗
▶ Ep 50 · 1:54
clinical Alpha fetal protein (AFP) is a screening test, but ultrasound imaging is needed to definitively diagnose abdominal wall defects. ↗
▶ Ep 50 · 1:54
clinical For gastroschisis, only ultrasound confirmed diagnosis is obtained without additional imaging. ↗
▶ Ep 50 · 1:54
clinical For omphalocele, besides ultrasound, MRI and echocardiogram are routinely obtained because these patients may have other associated anomalies. ↗
▶ Ep 50 · 1:54
clinical Fetal growth is tracked monthly in gastroschisis and omphalocele cases because there is concern for significant growth restriction. ↗
▶ Ep 50 · 2:56
clinical If surveillance imaging becomes worrisome enough regarding intrauterine fetal demise, the mother and fetus need to be admitted for continuous monitoring or emergent delivery. ↗
▶ Ep 50 · 2:56
clinical Biophysical profile and non-stress testing are needed because intrauterine growth restriction and intrauterine fetal demise (IUFD) can occur in these patients. ↗
▶ Ep 50 · 2:56
quote Inutero growth restriction, as well as IUFD in utero fetal demise, uh, can occur in this patient ↗
▶ Ep 50 · 3:27
epidemiological Gastroschisis is most common among babies born to young mothers of low gravidity, usually first pregnancy, with 75% being first born and 25% in second or subsequent pregnancies. ↗
▶ Ep 50 · 3:27
epidemiological Nearly 60% of gastroschisis cases are premature. ↗
▶ Ep 50 · 3:27
quote more than 90% of these infants born less than 2,500 grams in weight ↗
▶ Ep 50 · 3:27
quote It's, uh, most common among babies born to young mother of low gravity and usually first pregnancy. And 75% of that is the first born ↗
▶ Ep 50 · 3:27
epidemiological More than 90% of gastroschisis infants are born less than 2,500 grams in weight due to intrauterine growth restriction. ↗
▶ Ep 50 · 3:27
epidemiological Pseudoephedrine has an odds ratio of 4.2 times for gastroschisis compared to aspirin alone at 2.7. ↗
▶ Ep 50 · 3:27
epidemiological Other risk factors for gastroschisis include acetaminophen, vitamin B deficiencies, drug use, and some genetic predispositions. ↗
▶ Ep 50 · 4:19
epidemiological Mothers with omphalocele are usually advanced in age compared to the gastroschisis group, with advanced maternal age having an odds ratio of 3.3. ↗
▶ Ep 50 · 4:19
epidemiological Major risk factors for omphalocele are trisomy 13, 18, and 21, which occur in anywhere between 35 and 90% of patients with omphalocele. ↗
▶ Ep 50 · 5:02
clinical These babies can have significant acidosis and pulmonary hypertension. ↗
▶ Ep 50 · 5:02
clinical Crucial immediate postnatal procedures include minimizing heat loss and fluid loss, otherwise babies can show up extremely dehydrated and cold. ↗
▶ Ep 50 · 5:02
quote Minimizing heat loss and fluid loss in these babies. Otherwise they can show up, uh, extremely dehydrated as well as, um, being cold ↗
▶ Ep 50 · 5:34
quote If you have a bowel that look pretty pristine, non-thickened, non-inflammatory, only small amount of them being on the outside and that's enough abdominal domain, you can actually push them all back very quickly and perform primary closure ↗
▶ Ep 50 · 5:34
clinical Primary closure is considered if the bowel looks pristine, non-thickened, non-inflammatory, with only small amount outside and enough abdominal domain to push them all back very quickly. ↗
▶ Ep 50 · 6:07
clinical Staged closure is favored if the defect is large or there are issues with the bowel, including atresia, compromised bowel, or perforation. ↗
▶ Ep 50 · 6:07
clinical Some patients develop intestinal perforation after only two to four days of enteral feeding. ↗
▶ Ep 50 · 6:07
quote We favor stage closure if the defect is large or, um, there's issue with the bowel ↗
▶ Ep 50 · 6:58
clinical In sutureless closure, after pushing the bowel back in, babies are not taken to the operating room for suture closure; instead, the umbilical cord is placed over with dressing, and skin will grow over, although a small umbilical defect may remain that can close spontaneously over time. ↗
▶ Ep 50 · 6:58
quote After you push the bowel back in, uh, you don't take these babies to the operating room to close that with suture, but rather put the umbilical cord over and then the dressing over. And a lot of times skin will grow over ↗
▶ Ep 50 · 7:29
clinical For small bowel atresia encountered during closure, management options include tapering the dilated portion of bowel or resecting the bowel before tapering. ↗
▶ Ep 50 · 7:57
clinical For omphalocele with no significant respiratory issues, sequential reduction using meshes is the best option, sewing meshes to the edges of the fascia without interrupting the membrane. ↗
▶ Ep 50 · 8:43
clinical After sequential reduction with plastic clips, the patient is taken to the operating room for delayed primary closure of the fascia and skin. ↗
Omphalocele 36 entries

Omphalocele and Gastroschisis With Dr. Foong-Yen Lim

▶ Ep 8 · 0:55
clinical Gastroschisis is a full thickness abdominal wall defect just to the right of the umbilicus, in which peritoneal contents, most often intestines, protrude through the abdomen without any membranous cover. ↗
▶ Ep 8 · 0:55
clinical Omphalocele is right through the middle of the umbilicus and has a membranous cover. ↗
▶ Ep 8 · 0:55
clinical Omphalocele is a congenital disorder and can have associated anomalies, but gastroschisis occurs in otherwise normal babies that have an intrauterine event during development. ↗
▶ Ep 8 · 0:55
quote umbilical is a congenital disorder and can have associated anomalies, but gastroschisis occurs in otherwise normal babies that have an intrauterine event during development ↗
▶ Ep 8 · 0:55
quote gastroschisis is a full thickness abdominal wall defect just to the right of the umbilicus, in which peritoneal contents, most often intestines, protrude through the abdomen without any membranous cover ↗
▶ Ep 8 · 1:54
clinical Alpha fetal protein (AFP) is a screening test, but ultrasound imaging is needed to definitively diagnose abdominal wall defects. ↗
▶ Ep 8 · 1:54
clinical Very high level of alpha fetal protein is associated with gastroschisis or omphalocele. ↗
▶ Ep 8 · 1:54
quote If you see a very high level of alpha fetal protein, think about um, gastroschisis or emphalaceal ↗
▶ Ep 8 · 1:54
clinical For gastroschisis, only ultrasound confirmed diagnosis is obtained without additional imaging. ↗
▶ Ep 8 · 1:54
clinical For omphalocele, besides ultrasound, MRI and echocardiogram are routinely obtained because these patients may have other associated anomalies. ↗
▶ Ep 8 · 1:54
clinical Fetal growth is tracked monthly in gastroschisis and omphalocele cases because there is concern for significant growth restriction. ↗
▶ Ep 8 · 2:56
clinical If surveillance imaging becomes worrisome enough regarding intrauterine fetal demise, the mother and fetus need to be admitted for continuous monitoring or emergent delivery. ↗
▶ Ep 8 · 2:56
clinical Biophysical profile and non-stress testing are needed because intrauterine growth restriction and intrauterine fetal demise (IUFD) can occur in these patients. ↗
▶ Ep 8 · 2:56
quote Inutero growth restriction, as well as IUFD in utero fetal demise, uh, can occur in this patient ↗
▶ Ep 8 · 3:27
quote more than 90% of these infants born less than 2,500 grams in weight ↗
▶ Ep 8 · 3:27
quote It's, uh, most common among babies born to young mother of low gravity and usually first pregnancy. And 75% of that is the first born ↗
▶ Ep 8 · 3:27
epidemiological Pseudoephedrine has an odds ratio of 4.2 times for gastroschisis compared to aspirin alone at 2.7. ↗
▶ Ep 8 · 3:27
epidemiological Gastroschisis is most common among babies born to young mothers of low gravidity, usually first pregnancy, with 75% being first born and 25% in second or subsequent pregnancies. ↗
▶ Ep 8 · 3:27
epidemiological Nearly 60% of gastroschisis cases are premature. ↗
▶ Ep 8 · 3:27
epidemiological More than 90% of gastroschisis infants are born less than 2,500 grams in weight due to intrauterine growth restriction. ↗
▶ Ep 8 · 3:27
epidemiological Other risk factors for gastroschisis include acetaminophen, vitamin B deficiencies, drug use, and some genetic predispositions. ↗
▶ Ep 8 · 4:19
epidemiological Mothers with omphalocele are usually advanced in age compared to the gastroschisis group, with advanced maternal age having an odds ratio of 3.3. ↗
▶ Ep 8 · 4:19
epidemiological Major risk factors for omphalocele are trisomy 13, 18, and 21, which occur in anywhere between 35 and 90% of patients with omphalocele. ↗
▶ Ep 8 · 5:02
clinical These babies can have significant acidosis and pulmonary hypertension. ↗
▶ Ep 8 · 5:02
clinical Crucial immediate postnatal procedures include minimizing heat loss and fluid loss, otherwise babies can show up extremely dehydrated and cold. ↗
▶ Ep 8 · 5:02
quote Minimizing heat loss and fluid loss in these babies. Otherwise they can show up, uh, extremely dehydrated as well as, um, being cold ↗
▶ Ep 8 · 5:34
quote If you have a bowel that look pretty pristine, non-thickened, non-inflammatory, only small amount of them being on the outside and that's enough abdominal domain, you can actually push them all back very quickly and perform primary closure ↗
▶ Ep 8 · 5:34
clinical Primary closure is considered if the bowel looks pristine, non-thickened, non-inflammatory, with only small amount outside and enough abdominal domain to push them all back very quickly. ↗
▶ Ep 8 · 6:07
quote We favor stage closure if the defect is large or, um, there's issue with the bowel ↗
▶ Ep 8 · 6:07
clinical Staged closure is favored if the defect is large or there are issues with the bowel, including atresia, compromised bowel, or perforation. ↗
▶ Ep 8 · 6:07
clinical Some patients develop intestinal perforation after only two to four days of enteral feeding. ↗
▶ Ep 8 · 6:58
quote After you push the bowel back in, uh, you don't take these babies to the operating room to close that with suture, but rather put the umbilical cord over and then the dressing over. And a lot of times skin will grow over ↗
▶ Ep 8 · 6:58
clinical In sutureless closure, after pushing the bowel back in, babies are not taken to the operating room for suture closure; instead, the umbilical cord is placed over with dressing, and skin will grow over, although a small umbilical defect may remain that can close spontaneously over time. ↗
▶ Ep 8 · 7:29
clinical For small bowel atresia encountered during closure, management options include tapering the dilated portion of bowel or resecting the bowel before tapering. ↗
▶ Ep 8 · 7:57
clinical For omphalocele with no significant respiratory issues, sequential reduction using meshes is the best option, sewing meshes to the edges of the fascia without interrupting the membrane. ↗
▶ Ep 8 · 8:43
clinical After sequential reduction with plastic clips, the patient is taken to the operating room for delayed primary closure of the fascia and skin. ↗