Thoracoschisis: A Case Report and Review of Literature
Jordan D McKay1, Cecily M Parker1, Jonathan Loewen2
1a Department of Pediatric Pathology , Emory University School of Medicine, Children's Healthcare of Atlanta , Atlanta , Georgia , USA.
Insights
Thoracoschisis, a rare congenital defect, involves abdominal organs protruding through the chest wall. This case report details the successful surgical repair of thoracoschisis in a neonate with minimal cardiac anomalies.
Area of Science:
- Pediatric Surgery
- Congenital Malformations
- Thoracic Wall Defects
Background:
- Thoracoschisis is an extremely rare congenital birth defect.
- It involves intra-abdominal organs eviscerating through a thoracic wall defect.
- Previous cases suggest diaphragmatic anomalies indicate early developmental timing.
Observation:
- A neonate presented with left-sided thoracoschisis below the 8th intercostal space immediately after birth.
- The patient underwent surgical repair of the thoracoschisis.
Findings:
- Unlike most cases, this patient exhibited only small atrial septal defects, despite the known high prevalence of cardiac defects in thoracoschisis.
- The diaphragmatic anomaly, often seen in thoracoschisis, was not explicitly detailed in this case but implied by the defect's nature.
Implications:
- This case expands the understanding of thoracoschisis presentations, particularly regarding associated cardiac anomalies.
- Successful surgical repair in neonates underscores the importance of timely intervention for congenital thoracic wall defects.
- Further research into the embryological origins of thoracoschisis may elucidate the varied presentations and associated anomalies.
Abstract:
Thoracoschisis is an extremely rare congenital birth defect in which intra-abdominal organs eviscerate through a defect in the thoracic wall(1). There are only seven previously reported pediatric cases and in each case, there is some diaphragmatic anomaly, suggesting that the defect took place before complete formation of the diaphragm. Our patient was referred to us from a local hospital immediately after delivery. The patient was born with a thoracoschisis of the left side below the 8(th) intercostal space. The thoracoschisis was repaired. Although there is a high prevalence of cardiac defects among thoracoschisis patients, this patient shows only small atrial septal defects.
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