A novel surgical approach to thoracoschisis

Abstract

Thoracoschisis is a very rare congenital anomaly defined by the herniation of intra-abdominal organs through a defect in the thoracic wall, often associated with defects in the limb-body wall complex. We present a Case of a 33-week gestation female born with thoracoschisis between her left 7th and 8th ribs, with protrusion of her liver, stomach, spleen, small and large intestines. Owing to the amount of herniated organs and loss of abdominal domain, she required a silo placement initially followed by a delayed reduction of her abdominal contents. Due to a lack of abdominal wall musculature at the defect, she required a repair with biologic mesh and negative pressure wound vac therapy. Based on our review, this is the 7th reported Case of isolated thoracoschisis, and the only case with such extensive herniation of abdominal contents. An extensive search revealed only 15 reported cases of thoracoschisis in current literature. Given the rarity of thoracoschisis, we present our case, an approach for repair of a thoracoschisis defect using biologic mesh when primary repair is not feasible, and a review of the current literature.