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Gastroschisis Complicated by Colonic Atresia
Hayley M Everett1, S Dave Bhattacharya1
1Department of General Surgery, UTHSC COM Chattanooga, Chattanooga, TN, USA.
The American Surgeon
|November 3, 2021
Summary
Gastroschisis with colonic atresia is a rare and complex condition. This case highlights the significant challenges and increased complications associated with this combined congenital defect in neonates.
Area of Science:
- Pediatric Surgery
- Neonatal Care
- Gastrointestinal Surgery
Background:
- Gastroschisis with colonic atresia is a rare congenital anomaly.
- No standardized surgical approach exists due to its rarity and varied presentation.
- This combination presents higher morbidity and mortality than isolated gastroschisis or intestinal atresia.
Observation:
- A neonate with congenital gastroschisis required silo placement on day 1.
- Exploratory surgery on day 4 revealed bowel congestion and discoloration.
- The patient presented with oliguria, indicating potential complications.
Findings:
- Resection of terminal ileum and atretic cecum due to necrosis was necessary.
- Primary gastroschisis closure with end ileostomy was performed.
- Subsequent procedures included ileostomy takedown, anastomotic revision, and gastrostomy tube placement for dysmotility.
Implications:
- Gastroschisis with intestinal atresia leads to prolonged hospitalization, parenteral nutrition, and severe intestinal dysfunction.
- Necrosis of bowel, particularly the ileocecal region, is common.
- This complex surgical challenge necessitates further research and discussion for improved patient outcomes.
