Gastroschisis

• Causes, incidence, and risk factors

  Gastroschisis is a type of hernia. Hernia means "rupture.” Babies with this condition have a hole in the abdominal wall, usually on the right side of the umbilical cord. The child's intestines usually stick out (protrude) through the hole.

  The condition looks similar to an omphalocele. An omphalocele, however, is a birth defect in which the infant's intestine or other abdominal organs stick out of the belly button area and are covered with a membrane.

  Other related birth defects are rare in patients with gastroschisis.

• Symptoms
  • Lump in the abdomen
  • Intestine sticks through the abdominal wall near the umbilical cord
• Signs and tests

  Physical examination of the infant is enough for the health care provider to diagnose gastroschisis. The baby will have problems with movement and absorption in the gut, because the unprotected intestine is exposed to irritating amniotic fluid.

  The mother may have shown signs of too much amniotic fluid (polyhydramnios). A prenatal ultrasound often identifies the gastroschisis.

• Treatment

  If gastroschisis is found before birth, the mother will need special monitoring to make sure her unborn baby remains healthy. Plans should be made for careful delivery and immediate management of the problem after birth.

  Treatment for gastroschisis is surgery to repair the defect. A surgeon will put the bowel back into the abdomen and close the defect, if possible. If the abdominal cavity is too small, a mesh sack is stitched around the borders of the defect and the edges of the defect are pulled up. Over time, the herniated intestine falls back into the abdominal cavity, and the defect can be closed.

  Other treatments for the baby include nutrients by IV and antibiotics to prevent infection. The baby's temperature must be carefully controlled, because the exposed intestine allows a lot of body heat to escape.

• Expectations (prognosis)

  The child has a good chance of recovering if the abdominal cavity is large enough. A very small abdominal cavity may result in complications that require additional surgery.

• Complications

  The misplaced abdominal contents can make it difficult for the baby to expand the lungs, leading to breathing problems.

  Bowel death is another complication.

• Calling your health care provider

  This condition is apparent at birth and will be detected in the hospital at delivery. It may also be detected on routine fetal ultrasound exams. If you have given birth at home and your baby appears to have this defect, call the local emergency number (such as 911) immediately.

• References

  Ledbetter DJ. Gastroschisis and omphalocele. Surg Clin N Am. 2006;86:249-260.

Review Date: 11/2/2009

Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.