Gastroschisis

-Gastroschisis is the protrusion or extrusion of abdominal viscera through a defect in the abdominal wall, usually in the right side of umbilical cord insertion. 

- Gastroschisis is one of congenital disorder occur due to defect in anterior abdominal wall closure, allowing protrusion of the viscera.

- More common in males than females babies.

- The anomaly results from incomplete closure of lateral fold during the fourth weeks of development.

- In gastroschisis there is no membrane covering the intestine, as a result edema and erythematus of intestine occur due to a long inflammation of intestine following directly exposure to amniotic fluid. 

- Other common congenital defect seen in gastroschisis is gut malrotation, and other congenital birth defect are rarely seen.

- During delivery, exposed abdominal viscera should be covered with sterile saline soaked, followed by effective sterile dressing to prevent evaporation.

- Baby should be kept in a sterile bowel bag, contain warm saline to prevent evaporation and maintain sterility. 

- Baby is evaluated for other anomalies before surgery.

- The primary closure of abdominal defect is done when is possible, because the abdominal cavity may be small to accommodate the whole viscera. 

- In case were whole visceral can not be returned inside, it should be covering by silicon pouch in which as time, it reduced in size and abdominal cavity will increasing in size. 

 Thanks,      

                               MWANDA, MD.