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Gastroschisis or exomphalos? An unusual abdominal defect
Jayaram Sivaraj1,2, Tristan Boam2,3, Sara Gozzini2,4
1Department of General Surgery, North Middlesex University Hospital NHS Trust, London, UK jayaram.sivaraj@nhs.net.
BMJ Case Reports
|September 9, 2021
Summary
This case study describes an unusual birth defect, a rare form of exphalos mimicking gastroschisis. A novel silo management approach led to successful surgical closure and recovery.
Area of Science:
- Neonatal surgery
- Pediatric surgery
- Congenital anomalies
Background:
- Exomphalos and gastroschisis are distinct congenital abdominal wall defects.
- Accurate prenatal diagnosis and classification are crucial for management planning.
Observation:
- A term infant presented with a right-sided paraumbilical defect resembling gastroschisis.
- The defect featured a sac characteristic of exomphalos, containing abdominal organs and significant fluid.
- This presentation created diagnostic ambiguity between exomphalos and gastroschisis.
Findings:
- A composite management strategy was employed, combining elements for both conditions.
- Initial management involved draining the sac and utilizing a silo technique.
- Successful definitive surgical closure was achieved on day 3 of life.
Implications:
- This case highlights the importance of flexible management in ambiguous congenital anomalies.
- It suggests that a tailored, hybrid approach can be effective for complex abdominal wall defects.
- Further research into differentiating and managing such ambiguous presentations is warranted.
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