ABSTRACT
The abdominal wall forms during the fourth week of gestation from differential growth of the embryo causing infolding in the craniocaudal and mediolateral directions. The lateral abdominal folds of the embryo meet in the anterior midline and surround the yolk sac, eventually constricting the yolk sac into a yolk stalk that becomes the site of the umbilical cord. Various treatment options include silo placement in the neonatal unit or operating theatre, serial reductions and delayed abdominal wall closure, and primary or delayed reduction with umbilical cord closure. In many cases, the defect is large and the loss of domain in the peritoneal cavity prevents primary closure without an undue increase in intra-abdominal pressure. Escharotic therapy with silver sulfadiazine or other non-toxic antibacterial dressing, which results in gradual epithelialisation of the exomphalos sac, is another form of delayed closure that can be used in neonates who cannot tolerate an operation because of prematurity, congenital heart disease or other anomalies.
