This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Hernia, Subject name: Surgery
A male neonate is born with an omphalocele (shown in Figure below). This entity can be distinguished from gastroschisis, because in an omphalocele, the protrusion is:Giant omphalocele in a newborn male. 
Select and explain. 
A. Not covered by a sac, B. A defect in the abdominal musculature, C. Associated with an umbilicus attached to the abdominal wall musculature, D. Associated with partial or complete malrotation of the bowel
D: Associated with partial or complete malrotation of the bowel
Answer: D: Associated with partial or complete malrotation of the bowel 
Explanation: In omphalocele (see figure below), the swelling is covered by a membrane formed by the peritoneum, Wharton's jelly, and amnion. The membrane is transparent, and underlying intestine can be seen. The other features listed are characteristic of gastroschisis. In gastroschisis, the protrusion is not covered by a membrane and the other features listed apply.Radiograph shows large swelling due to gastroschisis. (Multiple loops of bowel lying on the right side and outside of the abdomen)Radiograph shows large swelling due to gastroschisis. (Bowel loops wrapped in synthetic bag to reduce bowel sequentially.)