Abstract
Gastroschisis and omphalocele reflect the two most common abdominal wall defects in newborns. First postnatal care consists of defect coverage, avoidance of fluid and heat loss, fluid administration and gastric decompression. Definitive treatment is achieved by defect reduction and abdominal wall closure. Different techniques and timings are used depending on type and size of defect, the abdominal domain and comorbidities of the child. The present review aims to provide an overview of current treatments.
Highlights
Gastroschisis is one of the most common congenital abdominal wall defects in newborns
Children born with gastroschisis have a full-thickness paraumbilical abdominal wall defect, which is associated with evisceration of bowel and sometimes other organs (Figure 1a)
Gastroschisis is typically accompanied by intestinal non-rotation and may be associated with intestinal atresia and/or perforations
Summary
In contrast to gastroschisis in omphaloceles the abdominal defect is covered by a membranous sac, consisting of three layers: peritoneum, Wharton’s jelly and amnion as the outermost layer. The umbilical cord/vessels insert at the apex of the sac, which typically contains herniated abdominal contents. These can vary depending on the size of the abdominal defect and include intestine, liver, spleen, bladder and/or gonads. Omphalocele has to be differentiated from gastroschisis, as there are a number of clinical differences between the two entities. While gastroschisis is rarely associated with other congenital anomalies, patients with omphalocele often have associated congenital or chromosomal anomalies. This in turn has a large influence on morbidity and mortality [65]. Survival in infants with omphalocele has significantly improved over the last years [66]
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