Gastrochisis
| Gastroschisis | |
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| Drawing of a child with gastroschisis | |
| Pronunciation |
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| Specialty | General surgery, medical genetics |
| Symptoms | Intestines extend outside of the body through a hole next to the belly button |
| Complications | Feeding problems, prematurity, intrauterine growth retardation |
| Usual onset | During early development |
| Causes | Unknown |
| Risk factors | Mother who smokes, drinks alcohol, or is younger than 20 |
| Diagnostic method | Ultrasound during pregnancy, based on symptom at birth |
| Similar conditions | Omphalocele, prune belly syndrome |
| Treatment | Early surgery |
| Frequency | 4 per 10,000 births |
| Classification |
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| External resources |
Gastroschisis is a birth defect in which the baby's intestines extend outside of the body through a hole next to the belly button. The size of the hole is variable, and other organs including the stomach and liver may also occur outside the baby's body. Complications may include feeding problems, prematurity, intestinal atresia, and intrauterine growth retardation.
The cause is typically unknown. Rates are higher in babies born to mothers who smoke, drink alcohol, or are younger than 20 years old.Ultrasounds during pregnancy may make the diagnosis. Otherwise diagnosis occurs at birth. It differs from omphalocele in that there is no covering membrane over the intestines.
Treatment involves surgery. This typically occurs shortly after birth. In those with large defects the exposed organs may be covered with a special material and slowly moved back into the abdomen. The condition affects about 4 per 10,000 newborns. Rates of the condition appear to be increasing.
There are no signs during pregnancy. About sixty percent of infants with gastroschisis are born prematurely. At birth, the baby will have a relatively small (<4 cm) hole in the abdominal wall, usually just to the right of the belly button. Some of the intestines are usually outside the body, passing through this opening. In rare circumstances, the liver and stomach may also come through the abdominal wall. After birth these organs are directly exposed to air.
The cause of gastroschisis is not known. There may be genetic causes in some cases, and there may be environmental factors to which the mother is exposed during pregnancy.
Risk factors include the mother being young, and use of alcohol or tobacco.
During the fourth week of human embryonic development, the lateral body wall folds of the embryo meet at the midline and fuse together to form the anterior body wall. However, in gastroschisis and other anterior body wall defects, this fails to occur by either one or both of the lateral body wall folds not moving properly to meet with the other and fusing together. This incomplete fusion results in a defect that allows abdominal organs to protrude through the abdominal wall, and the intestines typically herniate through the rectus abdominis muscle, lying to the right of the umbilicus. The forces responsible for the movement of the lateral body wall folds are poorly understood, and a better understanding of these forces would help to explain why gastroschisis occurs mostly to the right of the umbilicus, while other ventral body wall defects occur in the midline.
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Wikipedia