Case Of Gastroschisis Research Articles

Left-sided gastroschisis without eviscerated organs

gastroschisis is a rare malformation which is defined as presence of abdominal wall defect. This malformation usually occurs to the right side of the umbilicus. Its occurrence to the left side is more rare and usually it is accompanied with other findings. We presented a case of a left-sided gastroschisis with no eviscerated organs which represent the first case in the literature, and it was managed surgically.

Can fetal magnetic resonance imaging aid prognosis in gastroschisis: A multicenter study.

To assess the contribution and impact of fetal magnetic resonance imaging (MRI) in managing fetal gastroschisis. We conducted an observational retrospective study of gastroschisis patients at three fetal medicine centers from 2008 to 2019. The primary endpoint was the number of cases in which the MRI provided relevant information related to gastroschisis. A total of 189 patients were included, and our study group included 38 patients who underwent MRI. For the eight patients with suspected gastroschisis, MRI confirmed the diagnosis. In six cases, it provided additional relevant information (spiral turn, intestine ischemia, and bowel size discrepancy). For the 17 patients with ultrasound signs of additional gastrointestinal anomalies, MRI detected one case of unidentified complex gastroschisis on sonography. For the 13 patients undergoing routine MRI, no significant information was obtained. One termination of pregnancy and one fetoscopy were performed a few days after the MRI results. There was no subsequent follow-up or additional bowel complications to support management. Although MRI did not change the management of pregnancies complicated by fetal gastroschisis, patients presenting with fetal gastroschisis with intraabdominal bowel dilatation could benefit from MRI to allow for more precise prenatal counseling to predict postnatal intestinal complications before birth.

Gastroschisis, a congenital anterior abdominal wall defect: a rare clinical image.

Gastroschisis is a relatively rare birth defect in which the baby’s intestines (stomach, large or small intestines) extends outside of the abdominal wall or exit their body from a 2 to 5 cm hole, most often on the right side beside their belly button during fetal development. It occurs in about 1 in every 2,000 babies. We report a case of a large gastroschisis containing intestinal loop. A 29-year-old, primigravida, was referred to the centre for childbirth. Antenatally, at 24th weeks the fetus was diagnosed with a congenital malformation of the anterior abdominal wall. The ultrasound at 30 weeks, confirmed the diagnosis. At 37 plus weeks, she was taken for emergency caesarean section. A male child was born with the confirmation of presence of gastroschisis. Birth weight 3.2 Kg, height 54 cm with appearance, pulse, grimace, activity, and respiration (APGAR) score 8/9. At birth gastroschisis contained intestinal loop. Newborn was referred to neonatal intensive for further management.

Gastroschisis with malrotation, gut duplication and Meckel's diverticulum; a rare association

Gastroschisis is defined as a congenital anterior abdominal wall defect which is rarely associated with other congenital anomalies. Gastrointestinal anomalies are the most common associations including malrotation. Other gut anomalies like intestinal duplication and Meckel's diverticulum are very rare. Our report a rare case of gastroschisis who is associated with malrotation, intestinal duplication and Meckel's diverticulum.

Rare left-sided gastroschisis with isolated omental herniation

Gastroschisis is classically defined as a right-sided abdominal wall defect, resulting in the herniation of abdominal contents without a protective membrane. Left-sided gastroschisis is exceedingly rare compared to its classical right-sided counterpart, and rates of associated congenital defects appear to be different depending on the laterality of the gastroschisis. This is a case report of a newborn who presented with an abdominal wall defect that was not identified on prenatal ultrasound, with features that were most consistent with a left-sided gastroschisis with isolated omental herniation. A review of the literature suggests that this is the 34th reported case of left-sided gastroschisis. This case report did not receive any specific grant from funding agencies in public, commercial, or not-for-profit sectors. • Left-sided gastroschisis is a rare congenital abdominal wall defect. • This is the 34th reported case of left-sided gastroschisis. • Initial management should focus on preventing hypovolemia and protecting the bowel. • Primary closure is the preferred method of repair, when feasible. • Gastroschisis has a favorable prognosis, with survival rates exceeding 90%.

Giant gastroschisis with complete gastric herniation: A case report and review of the literature

Introduction: We report a case of gastroschisis seen in our center, highlighting the rarity of this clinical entity. The author equally reviewed the existing literature covering the epidemiology, etiopathogenesis, management options, and outcomes of gastroschisis in low-income countries in sub-Saharan Africa and compares the reports with middle-income and high-income countries across the world. Case presentation: A preterm female neonate with a clinical diagnosis of gastroschisis at a primary care center was referred to the Neonatology Service of our tertiary care institution. She received optimal resuscitation and interdisciplinary management. Besides, the baby underwent an initial covering with an improvised silo bag of exposed bowel with unfavorable outcomes. Conclusion: The specific etiological factors for gastroschisis are yet to be established. The condition is considered a multifactorial disease. More frequently than ever, it's becoming easy to make prenatal diagnosis utilizing ultrasonography with high yield. Gastroschisis is a low-prevalence disease with an excellent prognosis if initial management is adequate. Interestingly, the condition requires highly skilled personnel of both specialized and primary care. Once the clinicians are well equipped, they can readily ensure correct initial management. Besides, the patient can equally benefit from an appropriate and timely referral to tertiary care centers to avoid future complications.

A Case of Gastroschisis in a Patient Who was Born at Home From a Mother Without Prenatal Care

A Case of Gastroschisis in a Patient Who was Born at Home From a Mother Without Prenatal Care

Gastroschisis Following Treatment with High-Dose Methimazole in Pregnancy: A Case Report.

Hyperthyroidism in pregnancy is associated with a increased incidence of low birth weight, preterm birth and admission to the neonatal intensive care unit. However, available treatment options are limited. In this report, we present a case of fetal gastroschisis with a history of intrauterine exposure to methimazole. A 37-year-old woman was diagnosed with Grave’s disease 3 years before her pregnancy. She had a poor response to propylthiouracil and required high-dose methimazole before her pregnancy. During the first trimester, she received methimazole 120 mg/day. After her 12th week of pregnancy, she received block-and-replace therapy (levothyroxine [LT4] 50 µg/day) because of the risk of hypothyroidism, and the dose of methimazole was downtitrated to 60 mg/day. Fetal ultrasonography showed fetal growth retardation and gastroschisis at gestational week 33. The relationship between the very high doses of methimazole in the first trimester of pregnancy and the incidence of gastroschisis in this patient was not fully understood because evidence of a relationship between the use of antithyroid drugs in the first trimester and congenital abnormalities in the fetus is lacking. Furthermore block-and-replace therapy is not recommended in pregnancy because it requires a higher dose of methimazole. We recommend preconception counseling and early screening of thyroid function. The counseling should include the best timeline for pregnancy and a discussion of the risks and benefits of hyperthyroidism treatment options.

A Rare Case of Prolapsed and Everted Bladder through a Widely Patent Urachus with an Absent Omphalocele

A prolapsed and everted bladder through a widely patent urachus with an absent omphalocele is considered as an extremely rare and unique case, which requires emergency treatment and surgical intervention. A newly born baby was born at term and then referred from a district hospital for a mass at the umbilical region. She was referred as a case of gastroschisis, but she was eventually found to have a rare patent urachus with bladder eversion and prolapse onto the abdominal wall. The prolapsed bladder was repaired without any complications, and an umbilicoplasty was performed successfully. The infant recovered uneventfully and without any difficulty in voiding. A significant reduction in bladder dome inflammation as well as in mucosal necrosis can be obtained by performing the repair procedure as soon as possible.

Gastroschisis and Omphalocele: A Case report

Fetal gastroschisis and omphalocele are congenital defects of abdominal wall that are often diagnosed by prenatal ultrasound done for routine screening or for obstetric indications such as evaluating an elevated maternal serum alpha fetoprotein (AFP).Regular antenatal checkup and Prenatal ultrasound could potentially identify the overwhelming majority of abdominal wall defects and accurately distinguish omphalocele from gastroschisis. But in a developing country like Bangladesh neglected patients fail to seek antenatal visit and prenatal diagnosis. Here we report a case of gastroschisis and omphalocele diagnosed incidentally during last trimester.TAJ 2015; 28(2): 64-65

Gastroschisis and Omphalocele: A Case report

Fetal gastroschisis and omphalocele are congenital defects of abdominal wall that are often diagnosed by prenatal ultrasound done for routine screening or for obstetric indications such as evaluating an elevated maternal serum alpha fetoprotein (AFP).Regular antenatal checkup and Prenatal ultrasound could potentially identify the overwhelming majority of abdominal wall defects and accurately distinguish omphalocele from gastroschisis. But in a developing country like Bangladesh neglected patients fail to seek antenatal visit and prenatal diagnosis. Here we report a case of gastroschisis and omphalocele diagnosed incidentally during last trimester.TAJ 2014; 27(2): 58-62

Gastroschisis associated with intestinal duplication cyst

Abstract Introduction Gastroschisis is much less frequently associated with anomalies than omphalocele. The most common associated anomaly is gastrointestinal abnormalities. Intestinal atresia is found in 10–15% of cases of gastroschisis. Intestinal duplication is a very rare association. Case report We present a unique case of gastroschisis with an associated intestinal (colonic) duplication cyst in a 4 -day -old 36 weeks pre-term, delivered to a primiparous 16 year old mother, presenting on account of anterior abdominal wall defect with protrusion of bowel through a defect on the right side of the umbilical cord. Examination showed a tubular mass protruding through a 3 cm defect on the right side of the umbilical cord, with a narrow appendix -like appendage at the summit. Laparotomy was done within 24 h of admission. Findings include a protruding tubular mass adherent to the serosa and muscularis layer of the mid transverse colon and the adjacent greater omentum. Mass was excised. Results He did well postoperatively but developed surgical site infection which was managed by daily wound dressing. He was discharged 2weeks post operative and was doing well at last follow up visit. Histopathology confirmed smooth muscle lining of the cyst wall, with interspersed goblet cells within the mucosa. Conclusion This report underscores the importance of thorough examination of content of gastroschisis for prompt diagnosis of rare anomalies like intestinal duplication.

GASTROSCHISIS ASSOCIATED WITH COLONIC ATRESIA - CASE REPORT

We present an extremely rare case of gastroschisis associated with colonic atresia, anomaly seen in only 1.5-5% of all gastroschisis patients. Surgery for this anomaly can be very difficult due to the concomitant inflammation or other anomalies (mesenterium communae, volvulus, etc). Although prolonged intestinal dismotility is expected in these patients, mechanical obstruction must not be excluded in postoperative course, as it is explained in this case. Our case report demonstrates that primary colonic anastomosis is safe and well tolerated surgical procedure for these patients and that obstructive ileus is possible days after primary surgery and must not be overlooked.

Left-sided gastroschisis associated with situs inversus totalis

Abstract We present a case of gastroschisis associated with situs inversus totalis in a female neonate. To our knowledge, only a few case reports of left-sided gastroschisis have been reported in the world literature, especially one associated with situs inversus.

Gastroschisis with Concomitant Jejuno-Ileal Atresia Complicated by Jejunal Perforation.

Gastroschisis is an isolated structural anomaly rarely associated with other life-threatening anomalies. The most common associated gastrointestinal anomalies are intestinal atresia, Meckel's diverticulum and intestinal duplications. Intestinal atresia occurs in 10-15% of gastroschisis cases. [1] We herein report a case of gastroschisis with concomitant type III b jejuno-ileal atresia with perforation of the proximal dilated segment of jejunum with congenital short bowel successfully treated by primary anastomosis and primary abdominal closure.

Gastroschisis with Multiple Skeletal Deformities, Imperforate Anus and Absent Genitalia : A Rare Presentation

Gastroschisis is a rare type of congenital abdominal wall defect involving full thickness of anterior abdominal wall. Out of different varieties, gastroschisis is one of the severe forms with an incidence of about 1 in 10,000 live births. The deform- ity is more commonly seen in young mothers less than 20 years. They are usually small for gestational age and have a high mortality rate. Only 60% survive till the end of first year. Gastroschisis with intact bowel is known as simple and those with intestinal atresia, perforation and/or necrosis are called complex gastroschisis. Usually it is not associated with any other congenital malformations. We present a rare case of gastroschisis associated with other anomalies like limb defects, kyphosis, talipes equinovarus, imperforate anus, absence of external genitalia and nipples. This congenitally abnormal fetus was delivered by a 23 year old primy at 24 weeks of gestation and was diagnosed by ultrasound.

Successful management of discordant gastroschisis in monochorionic diamniotic twin: a case report

Background: Monochorionic diamniotic (MCDA) twin pregnancy with gastroschisis carries a poor prognosis. Live birth and well development of both twins are extremely rare. Case: The authors report a rare case of discordant gastroschisis in MCDA twin. Both twins were followed up nine months after intrapartum fetal operation, and both are in good health until now. Conclusion: This report expands successful management of discordant gastroschisis in MCDA twins. Early diagnosis, intensive prenatal care, and multidisciplinary consultation are recommended in management of discordant gastroschisis in MCDA twin.

Outcome of Diabetic Pregnancies in a Tertiary Referral Centre, Varanasi.

The study was done to determine the maternal and fetal outcome of pregnancies complicated by maternal diabetes either Gestational Diabetes Mellitus (GDM) or preexisting (type 1 or type 2) diabetes over a period from March 2011 to Feb 2013 in a tertiary care hospital, Varanasi. This is a retrospective audit of the maternal and fetal outcome of women who presented to the Sir Sundar Lal Hospital, Department of Obstetrics and Gynaecology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India from March 2011 to Feb 2013, with GDM or pre-existing type 1 or type 2 Diabetes with pregnancy. The audit group comprised 65 pregnancies (67 babies), of whom 27 had preexisting diabetes and 38 cases developed gestational diabetes. Pregnant women who were found to be diabetic preconceptionally or in the first trimester were classified as 'pre-existing diabetes'. There were total of 65 diabetic women in this retrospective study, 39 women were GDM (60%) while 26 women (40%) were having pre-existing diabetes (24 type 1 diabetes and 2 women were in type 2 diabetes group). There were 35 multigravid women (53.85%) and 30 primigravid women (46.15%). There were 39 (60%) women on Insulin. There were 42 Lower Segment Caesarean Section (64.62%) and 23 Spontaneous Vaginal Delivery (35.38%). In fetal and neonatal complications, there were three still births, one case of intrapartum death, and one case of shoulder dystocia. Fetal anomalies were less frequent, one case of Gastroschisis with Hydrocephalus associated with Menigomyelocoele, there was one case of isolated Hydrocephalus, and there was also one case of Truncus arteriosus. The study analyses maternal and fetal complication in the GDM group and also preexisting diabetes group. In our centre, the 60% women were GDM while 40% were having pre-existing diabetes. Total rate of fetal/neonatal complication rate was 7.69% and of congenital anomaly rate it was 9.23%. Proportion of still birth, Intrauterine death, and congenital malformations was higher in the pre-existing diabetes group although the data are not large enough to draw a statistically significant conclusion. LSCS rate was little higher in the GDM group (69.23%) in comparison to the preexisting diabetes group where it was 57.69%. SVD (Spontaneous Vaginal Delivery) rate was 30.77% in GDM and 42.31% in the pre-existing diabetes group. HbA1c was within normal range 84.62% of GDM group while in 15.38% it was raised >6%. In the pre-existing diabetes group, only 19.23% of women had HbA1c within acceptable range and 80.77% had it >6. The aim of St Vincent Declaration is to 'achieve pregnancy outcome in the diabetic woman that is similar to that of the non-diabetic woman.' But, so far we have not been able to achieve this. Our HbA1c level is remarkably high in the pre-existing diabetes group. Only 3 out of 65 patients' women took Folic Acid periconceptionally. We need to work to achieve it our best. It is well known that insulin treatment during pregnancy results in reduction in the rate of macrosomia, fetal/neonatal, and maternal complications. Therefore, we need to use insulin judiciously and advocate its usage in the situations where it is needed.

Left-Sided Gastroschisis: A Rare Congenital Abdominal Wall Defect

Gastroschisis is a congenital abdominal wall defect that occurs at the immediate right of the umbilicus. Left-sided gastroschisis, which is located in the left periumbilical region, is extremely rare, as only 22 cases have been reported worldwide. Although most cases of gastroschisis are not complicated by other anomalies, extraintestinal anomalies are more commonly associated with left-sided gastroschisis than classic right-sided gastroschisis. In this report, we describe a case of left-sided gastroschisis complicated by cardiac anomalies. We also discuss the suggested theories of its pathogenesis and present a literature review. For patients with leftsided gastroschisis, we recommend evaluation of the associated anomalies because extraintestinal anomalies in the genitourinary, cardiovascular, or central nervous systems are more common in left-sided gastroschisis than in classic right-sided gastroschisis.

The Combination of Gastroschisis, Jejunal Atresia, and Colonic Atresia in a Newborn.

We encountered a rare case of gastroschisis associated with jejunal atresia and colonic atresia. In our case, the jejunal atresia was not discovered for 27 days after the initial abdominal wall closure. The colonic atresia was not discovered for 48 days after initial repair of the gastroschisis secondary to the rarity of the disorder. Both types of atresia were repaired with primary hand-sewn anastomoses. Other than the prolonged parenteral nutrition and hyperbilirubinemia, our patient did very well throughout his hospital course. Based on our case presentation, small bowel atresia and colonic atresia must be considered in patients who undergo abdominal wall closure for gastroschisis with prolonged symptoms suggestive of bowel obstruction. Our case report also demonstrates primary enteric anastomosis as a safe, well-tolerated surgical option for patients with types of intestinal atresia.