A Challenging Case of Closing Gastroschisis With Gangrenous Bowel: A Case Report

Gastroschisis is a rare congenital anomaly characterized by herniation of abdominal viscera through a right-sided abdominal wall defect without a protective membrane, typically identified during prenatal imaging. One of its most serious forms, known as closing gastroschisis, may result in bowel strangulation and significant clinical challenges. We report the case of a Yemeni male neonate delivered at 34 weeks of gestation via emergency cesarean section following premature rupture of membranes. At birth, the infant presented with a small abdominal wall defect and herniated bowel that appeared dusky, gangrenous, and foul-smelling. Emergency laparotomy revealed extensive bowel necrosis requiring resection and stoma formation. Although the postoperative period was initially stable, the neonate developed cholestasis associated with total parenteral nutrition (TPN) and a stoma prolapse, both of which contributed to feeding intolerance. Despite supportive management, the infant died at three months of age due to intestinal failure-associated liver disease. This case illustrates the complexity of managing closing gastroschisis and underscores the importance of early intervention, careful nutritional planning, and long-term supportive strategies to improve outcomes.