Sections View Full Chapter Figures Tables Videos Full Chapter Figures Tables Videos Supplementary Content + • Gastroschisis: Associated with other abnormalities 10% of time, most often intestinal atresia, associated with preterm infants• Omphalocele: Associated with other abnormalities 50% of time, nearly always full-term infants +++ Epidemiology + • Gastroschisis: 1/3000-1/8000 births• Omphalocele 1/6000-1/10,000 births +++ Symptoms and Signs + • Gastroschisis nearly always located to right of umbilicus, inflamed bowel and foreshortened mesentery secondary to exposure to amniotic fluid• Umbilical cord part of sac in omphalocele along with peritoneum +++ Imaging Findings + • Abdominal wall defect often noted with prenatal US + • Associated congenital abnormalities, especially intestinal atresia with gastroschisis +++ Rule Out + • Intestinal atresia with gastroschisis + • History and physical exam• Chest film• Echocardiogram (for omphalocele)• Renal US (for omphalocele)• CBC• Metabolic panel +++ Surgery + • Primary repair possible in 60-70%• Silastic pouch or silo construction followed by gradual reefing and eventual closure• Giant omphaloceles: Nonoperative initial therapy, gradual epithelialization, and closure months to years later +++ Medications + • Total parenteral nutrition during resolution of ileus +++ Complications + • Abdominal compartment syndrome• Necrotizing enterocolitis (15% in gastroschisis)• Delayed ileus or intestinal dysmotility (especially in gastroschisis) +++ References ++Lunzer H, Menardi G, Brezinka C: Long-term follow-up of children with prenatally diagnosed omphalocele and gastroschisis. J Matern Fetal Med 2001;10:385. [PubMed: 11798448] ++Molik KA et al: Gastroschisis: a plea for risk categorization. J Pediatr Surg 2001;36:51. [PubMed: 11150437] ++Sandler A, et al.: A Plastic sutureless abdominal wall closure in gastroschisis. J Pediatr Surg 2004;39:738. [PubMed: 15137009] GET ACCESS TO THIS RESOURCE Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth Get Free Access Through Your Institution Contact your institution's library to ask if they subscribe to McGraw-Hill Medical Products. Access My Subscription GET ACCESS TO THIS RESOURCE Subscription Options Pay Per View Timed Access to all of AccessSurgery 24 Hour $34.95 (USD) Buy Now 48 Hour $54.95 (USD) Buy Now Best Value AccessSurgery Full Site: One-Year Individual Subscription $995 USD Buy Now View All Subscription Options