Challenges in Managing Closed Gastroschisis: Addressing a Rare and Complex Variant of Abdominal Wall Defect

In closed gastroschisis, the initial herniation of the intestines through the abdominal wall defect subsequently leads to spontaneous closure of the defect during fetal development, even before the migration of the intestines back to the abdominal domain.

This study investigates the clinical presentation, diagnostic challenges, and management strategies of closed gastroschisis through a retrospective review of six cases presented at our clinic between 2009 and 2024. Data were prospectively collected and analyzed to gain insights into the varied presentations and outcomes of this rare condition.

In this cohort of six patients with closed gastroschisis, none had undergone antenatal ultrasonographic examination, and all presented to the emergency department immediately after birth with a mass protruding from the abdominal wall. Each patient underwent evaluation and laparotomy for definitive management. Five of the six children showed favorable outcomes at the 48-month follow-up, while one patient succumbed to postoperative sepsis.

Abdominal wall defects, including closed gastroschisis, are congenital anomalies requiring prompt diagnosis and treatment. This rare variant presents unique challenges in management due to its atypical features. The findings from this study contribute to a better understanding of closed gastroschisis and its management, highlighting the importance of early diagnosis and intervention in improving patient outcomes in pediatric surgical practice. Antenatal diagnosis and prompt surgical intervention as early as possible after birth are the mainstays of treatment.