Abstract
Gastroschisis and omphalocele are the two most common congenital abdominal wall defects. In gastrochisis, loops of intestine, stomach, and occasionally gonads herniate out of the abdominal cavity and are exposed to amniotic fluid. The intestine often develops an inflammatory covering with a matted appearance at birth. The etiology is not known, but the incidence is increasing worldwide. A vast majority of these defects are detected by prenatal ultrasound and delivered at a center with pediatric surgical expertise. Controversy exists over the timing and route of delivery. Some centers prefer preterm cesarean deliveries but most recommend term vaginal delivery. Postnatal management consists of closure of the defect either immediately or in a delayed fashion with the use of a silo. Mortality has dramatically declined over the past four decades with survival rates greater than 96 % for simple gastroschisis. Complex gastroschisis includes those with an associated atresia, limited intestinal length, bowel ischemia, or perforation and is associated with a longer hospital stay and poorer outcomes.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
Suggested Reading
Bergholz R, Boettcher M, Reinshagen K, Wenke K. Complex gastroschisis is a different entity to simple gastroschisis affecting morbidity and mortality – a systematic review and meta-analysis. J Pediatr Surg. 2014;49:1527–32.
Cowan KN, Puligandla PS, Laberge J-M, et al. The gastroschisis prognosis score: reliable outcome prediction in gastroschisis. J Pediatr Surg. 2012;47:1111–7.
Feldkamp ML, Carey JC, Sadler TW. Development of gastroschisis: review of hypotheses, a novel hypothesis, and implications for research. Am J Med Genet A. 2007;143:639–52.
Islam S. Advances in surgery for abdominal wall defects: gastroschisis and omphalocele. Clin Perinatol. 2012;39:375–86.
Kunz SN, Tieder JS, Whitlock K, et al. Primary fascial closure vs. staged closure with silo in patients with gastroschisis: a meta analysis. J Pediatr Surg. 2013;48:845–57.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2017 Springer International Publishing AG
About this chapter
Cite this chapter
Islam, S. (2017). Gastroschisis. In: Mattei, P., Nichol, P., Rollins, II, M., Muratore, C. (eds) Fundamentals of Pediatric Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-27443-0_68
Download citation
DOI: https://doi.org/10.1007/978-3-319-27443-0_68
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-27441-6
Online ISBN: 978-3-319-27443-0
eBook Packages: MedicineMedicine (R0)