Gastroschisis a fifteen-year experience

Seventeen neonates with gastroschisis were treated in the Paediatric Surgical Unit at the University of Nigeria Teaching Hospital, (UNTH), Enugu, between January 1971 and December 1985. The incidence of such babies who are alive to reach the Paediatric Surgeon has steadily increased. An overall mortality of 64.7% is noted but improvement in management has resulted in only two deaths in the last three years (33.3%). The decrease in mortality stems from efficient pre- and post-operative management, emphasizing preservation of body heat, decompression of stomach by nasogastric drainage, evacuation of reconium by rectal irrigation and total parenteral feeding. Stretching of the abdominal wall and primary closure is presently the treatment of choice. The occasional use of respiratory assistance contributed to the support of the infant in the immediate post-operative period.