Vanishing gastroschisis with jejunal atresia and extreme short bowel syndrome: A case series

Naresh Pawar,Punit Singh Parihar,Manika Boipai,Pramila Sharma

doi:10.47338/jns.v10.932

Naresh Pawar, Punit Singh Parihar + Show 2 more

Open Access

https://doi.org/10.47338/jns.v10.932

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Abstract

Background: Vanishing gastroschisis may occur due to spontaneous partial or complete closure of anterior abdominal wall defect around the viscera, leading to small bowel ischemia and resultant entry/exit level atresia and extremely short length of the remaining bowel. The prognosis is very poor, even after aggressive surgery, and requires prolonged total parenteral nutrition. Case Series: We report two female neonates, one with closed and another with closing vanishing gastroschisis, associated with jejunal atresia and extreme short bowel syndrome. In both patients, the antenatal scans showed gastroschisis without the evidence of vanishing gastroschisis. In both neonates, palliative surgeries were done. Both patients died after a few days due to short bowel syndrome and sepsis. Conclusion: When antenatally detected gastroschisis presents with closed or closing anterior abdominal wall defect, (vanishing gastroschisis), the parents/caregivers must be counseled about the poor prognosis of this condition. A tailored approach to either palliation or aggressive therapy is essential in this rare condition.

Highlights

Gastroschisis is characterized by the herniation of the midgut and occasionally other abdominal viscera through an anterior abdominal wall defect (AAWD), on the right of the umbilicus insertion, into the amniotic sac.[1,2] There has been an increase in the incidence of gastroschisis from 2.5 to 4.4 per 10000 live births over the past few decades.[3]
Case Series: We report two female neonates, one with closed and another with closing vanishing gastroschisis, associated with jejunal atresia and extreme short bowel syndrome
When antenatally detected gastroschisis presents with closed or closing anterior abdominal wall defect, the parents/caregivers must be counseled about the poor prognosis of this condition

Summary

Background

Vanishing gastroschisis may occur due to spontaneous partial or complete closure of anterior abdominal wall defect around the viscera, leading to small bowel ischemia and resultant entry/exit level atresia and extremely short length of the remaining bowel. Case Series: We report two female neonates, one with closed and another with closing vanishing gastroschisis, associated with jejunal atresia and extreme short bowel syndrome. In both patients, the antenatal scans showed gastroschisis without the evidence of vanishing gastroschisis. The antenatal scans showed gastroschisis without the evidence of vanishing gastroschisis In both neonates, palliative surgeries were done. Both patients died after a few days due to short bowel syndrome and sepsis

Conclusion

INTRODUCTION

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DISCUSSION