Abstract
A female infant is born at 35 weeks’ gestational age via spontaneous vaginal delivery to 22-year-old healthy mother with no significant medical history. The infant has complex gastroschisis with multiple perforations and colonic atresia. The pregnancy course was complicated by a positive result on quad screening and a positive structural survey of the fetus for gastroschisis and polyhydramnios. The infant undergoes gastroschisis repair and conversion of colonic atresia to colostomy soon after birth. Initial transthoracic echocardiography (TTE) findings on the second day after birth are normal except for the presence of a small patent foramen ovale. The postoperative course is complicated by culture-negative sepsis and feeding intolerance. On day 43, the infant develops bilious emesis and tense abdominal distension. Exploratory laparotomy and extensive lysis of adhesions are performed. On day 45, the infant develops clinical signs of abdominal compartment syndrome (ACS), requiring repeat laparotomy and the creation of a silo by placing a vacuum-assisted wound closure device. The patient develops oliguric acute kidney injury (AKI), acute respiratory distress syndrome …
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