[Closing gastroschisis: a distinct entity with high morbidity and mortality]
Ultraschall in Der Medizin (Stuttgart, Germany : 1980)
|August 9, 2012
Summary
Closing gastroschisis, a rare condition where the abdominal wall narrows around intestines, can cause severe bowel damage. Early prenatal ultrasound detection is crucial for timely delivery to prevent complications like short gut syndrome.
Area of Science:
- Perinatology
- Fetal Surgery
- Neonatalogy
Background:
- Gastroschisis is a congenital defect where intestines protrude outside the abdomen.
- Severe bowel damage in gastroschisis can result from intrauterine abdominal wall narrowing, termed "closing gastroschisis."
Purpose of the Study:
- To correlate severe bowel damage in gastroschisis with the intrauterine event of abdominal wall narrowing.
- To identify prenatal ultrasound markers for early diagnosis of closing gastroschisis.
- To enable timely delivery and prevent short gut syndrome.
Main Methods:
- Retrospective review of prenatal and postnatal courses of gastroschisis patients (2007-2009).
- Identification of 5 cases with suspected or confirmed closing gastroschisis.
- Correlation of prenatal ultrasound findings with postnatal intestinal damage.
Main Results:
- No consistent ultrasound markers for prenatal diagnosis of closing gastroschisis were identified.
- Three patients with significant prenatal gastric dilation experienced severe outcomes, including death or short gut syndrome.
- One case showed progressive intraabdominal loop dilation correlating with midgut necrosis.
Conclusions:
- Closing gastroschisis is a distinct, severe form of gastroschisis.
- Early diagnosis through longitudinal ultrasound observation, particularly progressive intraabdominal loop dilation, is vital.
- Timely delivery is essential to mitigate life-threatening intestinal damage and avoid short gut syndrome.
