Gastroschisis

Causes and Risks:
A gastroschisis is similar to an omphalocele in appearance. The two conditions differ in that an omphalocele is a herniation of the abdominal contents through the umbilical cord and is covered with peritoneum (the abdominal membrane); while a gastroschisis is a herniation through the abdominal wall (usually near the cord) but not involving the cord and the herniation is not covered with peritoneum. As in omphalocele, the abdominal cavity may be small and replacement of the bowel into the cavity may require several weeks in which the abdominal cavity is gently stretched to accommodate the mass.

Prevention:
There is no known prevention.

Symptoms:



Signs and Tests:
Physical examination of the infant is sufficient for the health care provider to diagnose gastroschisis. The mother may have shown signs indicating excessive amniotic fluid ( polyhydramnios ).

Treatment:
The bowel is surgically replaced in the abdomen and the defect closed if there is adequate room. If the abdominal cavity is too small, a mesh sack is sutured around the margins of the abdominal defect and the edges of the defect are pulled up. Gravity draws the herniated intestine back into the abdominal cavity, slowly stretching it to the point where the defect can be closed.

Prognosis:
Recovery is good if the abdominal cavity is relatively large enough. A very small abdominal cavity may result in complications requiring additional surgery.

Complications:

  • respiratory distress (the misplaced abdominal contents can cause difficulty with expansion of the lungs)
  • bowel death ( necrosis )



Call Your Healthcare Provider:
This condition is apparent at birth and will be detected in the hospital at delivery. It may also be detected on routine fetal ultrasound exams.


This picture shows an infant born with a defect in the abdominal wall near the umbilicus (gastroschisis). The bowel protrudes through the opening, and has been covered with a wet gauze dressing to help maintain the infant's body temperature and fluids. This birth defect requires prompt surgical treatment.



This picture shows an infant born with a defect in the abdominal wall near the umbilicus (gastroschisis) with protruding bowel. This birth defect requires prompt surgical treatment.