Figure 2. Example of a ruptured upper omphalocele with the liver and the entire gastrointestinal tract outside. A heart abnormality, sternal (breast bone) cleft, and hole in the front of the diaphragm also were present which is seen with the rare pentalogy of Cantrell. (From Grosfeld JL: Congenital abdominal wall defects: Current management and survival. Surg Clin North Am 61:1037, 1981.)