Gastroschisis

Budi Ikhsan, dr

What is gastroschisis?

• An opening in the abdominal wall through which the internal organs push outside of the baby's body

• Usually on the right side of the umbilical cord

• The child's intestines can be easily seen

Causes

• It occurs in approximately 1 out of every 5,000 births

• The cause of gastroschisis is unknown, but it is associated with younger maternal age and almost never occurs in mothers over 30 years of age

• It is not related to anything the mother ate or did during pregnancy

Symptoms

• Lump in the abdomen

• Intestine sticks through the abdominal wall near the umbilical cord

• Problems with movement and absorption in the gut due to the unprotected intestine being exposed to irritating amniotic fluid

Exams 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)

• Prenatal ultrasonography often identifies the gastroschisis

Treatment

• If identified before birth, mothers with gastroschisis need special monitoring to make sure the unborn baby remains and healthy

• Plans should be made for careful delivery and immediate management of the problem after birth

Treatment

• Treatment for gastroschisis is surgery. A surgeon will put the bowel back into the abdomen and close the defect, if possible

• If the abdominal cavity is too small, a mesh sack is stitched around the borders of the defect and the edges of the defect are pulled up

• Over time, the herniated intestine falls back into the abdominal cavity, and the defect can be closed

Treatment

• Other treatments for the baby include nutrients by IV and antibiotics to prevent infection

• The baby's temperature must be carefully controlled, since the exposed intestine allows a lot of body heat to escape

Outlook (Prognosis)

• Likelihood of recovery is good if the abdominal cavity is relatively large enough

• A very small abdominal cavity may result in complications requiring additional surgery

Possible Complications

• The misplaced abdominal contents can make it difficult for the baby to expand the lungs, leading to breathing problems

• Bowel death is another complication

Thank you