The etiology of gastroschisis is still unclear. To the authors’ knowledge, there are only 14 cases of familial gastroschisis in the literature. The authors add the second case of motherand-son occurrence and a case o...The etiology of gastroschisis is still unclear. To the authors’ knowledge, there are only 14 cases of familial gastroschisis in the literature. The authors add the second case of motherand-son occurrence and a case of siblings occurrence, thereby updating the current literature for family gastroschisis.展开更多
Purpose: The authors developed a clinical pathway for optimal management afte r antenatal diagnosis of gastroschisis. This is the outcomes analysis of our fir st 30 consecutive patients. Method: Antenatal counseling w...Purpose: The authors developed a clinical pathway for optimal management afte r antenatal diagnosis of gastroschisis. This is the outcomes analysis of our fir st 30 consecutive patients. Method: Antenatal counseling was provided for all fa milies with in- utero diagnosis of gastroschisis. Bowel dilatation, thickness, motility, amniotic fluid volume, and fetal development were followed by ultrason ography every 4 weeks. Babies were delivered by cesarean section between 36 and 38 weeks gestation if the lungs were mature or earlier for bowel complications. Gastroschisis repair was scheduled 90 minutes after birth. Primary repair was at tempted in all through the abdominal wall defect without an additional incision, resulting in an umbilicus with no abdominal scar. Results: Primary repair was a chieved in 83% . Babies needed assisted ventilation for 3 days, reached full fe eds by 19 days, and were discharged by 24 days (all medians). There were 3 (10% ) deaths, all after staged repair. Conclusions: Our new protocol of both schedu led elective cesarean section and early gastroschisis repair resulted in a highe r proportion of primary repair, shorter duration of mechanical ventilation, earl ier full feeds, and shorter length of stay. There was no increase in mortality o r morbidity. The primary repair babies had no mortality and had excellent cosmes is.展开更多
Silo pouch formation is a standard procedure to prevent compartment syndrome in gastroschisis. Intestinal complications such as perforation and volvulus can occur and their management can be perplexing. We present thr...Silo pouch formation is a standard procedure to prevent compartment syndrome in gastroschisis. Intestinal complications such as perforation and volvulus can occur and their management can be perplexing. We present three such patients in which we formed a stoma through the silo pouch owing to these complications. Creation of stoma through the silo is a novel, safe temporizing technique to decompress the bowel while delayed reduction continues. Subsequently, when the baby and the bowel improve, the stoma can be closed.展开更多
文摘The etiology of gastroschisis is still unclear. To the authors’ knowledge, there are only 14 cases of familial gastroschisis in the literature. The authors add the second case of motherand-son occurrence and a case of siblings occurrence, thereby updating the current literature for family gastroschisis.
文摘Purpose: The authors developed a clinical pathway for optimal management afte r antenatal diagnosis of gastroschisis. This is the outcomes analysis of our fir st 30 consecutive patients. Method: Antenatal counseling was provided for all fa milies with in- utero diagnosis of gastroschisis. Bowel dilatation, thickness, motility, amniotic fluid volume, and fetal development were followed by ultrason ography every 4 weeks. Babies were delivered by cesarean section between 36 and 38 weeks gestation if the lungs were mature or earlier for bowel complications. Gastroschisis repair was scheduled 90 minutes after birth. Primary repair was at tempted in all through the abdominal wall defect without an additional incision, resulting in an umbilicus with no abdominal scar. Results: Primary repair was a chieved in 83% . Babies needed assisted ventilation for 3 days, reached full fe eds by 19 days, and were discharged by 24 days (all medians). There were 3 (10% ) deaths, all after staged repair. Conclusions: Our new protocol of both schedu led elective cesarean section and early gastroschisis repair resulted in a highe r proportion of primary repair, shorter duration of mechanical ventilation, earl ier full feeds, and shorter length of stay. There was no increase in mortality o r morbidity. The primary repair babies had no mortality and had excellent cosmes is.
文摘Silo pouch formation is a standard procedure to prevent compartment syndrome in gastroschisis. Intestinal complications such as perforation and volvulus can occur and their management can be perplexing. We present three such patients in which we formed a stoma through the silo pouch owing to these complications. Creation of stoma through the silo is a novel, safe temporizing technique to decompress the bowel while delayed reduction continues. Subsequently, when the baby and the bowel improve, the stoma can be closed.
