Closed Gastroschisis: A Rare Abdominal Wall Defect.

Area of Science:

• Neonatal surgery
• Congenital abnormalities
• Pediatric surgery

Background:

• Gastroschisis is a congenital abdominal wall defect where intestines protrude outside the body.
• In rare instances (<6%), the defect closes in utero, a mechanism not fully understood.
• In utero closure can cause a tourniquet effect, potentially leading to intestinal atresia and infarction.

Observation:

• A female neonate was diagnosed prenatally with gastroschisis.
• At delivery, the abdominal wall defect was found to be closed.
• The infant presented with symptoms of intestinal obstruction and bowel ischemia.

Findings:

• The case highlights a rare instance of spontaneous in utero closure of gastroschisis.
• The neonate required immediate surgical intervention due to complications arising from the closed defect.
• The findings underscore the potential for adverse outcomes despite in utero defect closure.

Implications:

• Further research is needed to elucidate the mechanism of spontaneous gastroschisis closure.
• Understanding this mechanism could inform prenatal counseling and management strategies.
• This case emphasizes the importance of vigilant postnatal monitoring for infants with prenatally diagnosed gastroschisis, even with apparent in utero closure.