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Elliot K. Fishman, MD
Director of Diagnostic Imaging and Body CT, Professor of Radiology and Radiological Science, Johns Hopkins
Karen M. Horton, MD
Professor and Interim Chair, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins

This is a newborn child who presented with a congenital abnormality. A frontal radiograph of the chest and abdomen was obtained. The abdominal radiograph demonstrates a paucity of bowel gas within the abdomen. The red arrow illustrates loops of bowel surrounded by air outside the abdominal cavity. The green arrows point to a radiopaque device known as a silo which surrounds the extrabdominal bowel contents. A silo is a sterile device applied at birth for children with abdominal wall defects. The silo helps to prevent infection until surgery can be performed. This child has a defect known as gastroschisis, where the abdominal wall defect occurs lateral to midline and there is no sac covering the intestine. The other abdominal wall defect that occurs is known as an omphalocele, where the intestines herniate through a midline abdominal wall defect but are covered by a sac.