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DOI: 10.1055/s-0029-1216380
© Georg Thieme Verlag KG Stuttgart · New York
The Outcome of Closing Gastroschisis: Two Case Reports and Literature Review
Publication History
Publication Date:
22 June 2009 (online)
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Introduction
Gastroschisis is a relatively common neonatal surgical condition occurring in approximately 2–4. 9 of 10 000 live births [4]. Closing gastroschisis, where there is progressive and often complete closure of the abdominal wall defect in utero, has been reported only 33 times so far in the literature and has a mortality rate of 61%. The cardinal features of closing gastroschisis include a decreasing size of the extra-abdominal bowel herniation on serial ultrasound scans, often associated with intra-abdominal bowel dilatation [6]. We describe the antenatal findings and postnatal follow-up in the following report, highlighting the pathology in the postnatal period and the antenatal ultrasound scan pictures that show the progression of this rare phenomenon. The risk of short bowel syndrome and its complications are higher in these children, largely due to total parenteral nutrition, (TPN), related sepsis, liver failure and failed intestinal adaptation.
References
- 1 Anveden-Hertzberg L, Gauderer MWL. Paraumbilical intestinal remnant, closed abdominal wall and midgut loss in a neonate. J Pediatr Surg. 1996; 31 862-863
- 2 Celayir S, Besik C, Sarimurat N. et al . Prenatally detected gastroschisis presenting as jejunal atresia due to vanishing bowel. Pediatr Surg Int. 1999; 15 582-583
- 3 Davenport M, Haugen S, Greenough A. et al . Closed gastroschisis: antenatal and postnatal features. J Pediatr Surg. 2001; 36 1834-1837
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4 Klein MD. Congenital defects of the abdominal wall. In: Grosfeld JL, O’Neill JA, Foukalsrud EW et al. eds.
Pediatric Surgery Vol 2. 6th Edition . Philadelphia: Mosby Elsevier 2006: 1157-1171 - 5 Mc Mahon MJ, Kuller JA, Chescheir NC. Prenatal ultrasonographic associated with short bowel syndrome in two fetuses with gastroschisis. Obstet and Gynecol. 1996; 88 676-678
- 6 Tawil A, Comstock CH, Chang C. Prenatal closure of abdominal defect in gastroschisis: Case report and review of the literature. Pediat Dev Pathol. 2001; 4 580-584
- 7 Vogler SA, Fenton SJ, Scaife ER. et al . Closed gastroschisis: total parenteral nutrition-free survival with aggressive attempts at bowel preservation and intestinal adaptation. J Pediatr Surg. 2008; 43 1006-1010
- 8 Winter LW, Guiseppetti M, Breuer CK. A case report of midgut atresia and spontaneous closure of gastroschisis. Pediatr Surg Int. 2005; 21 415-416
Correspondence
Dr. S. Lawther
Royal Hospital for Sick Children
Department of Surgical Pediatrics
180 Falls Road
Belfast
United Kingdom
BT12 6BE
Phone: 7717/80/55 15
Fax: 2890/63 28 02
Email: s_lawther78@hotmail.com