Small-bowel continuity : a crucial factor in determining survival in gastroschisis

• Published in: Pediatric surgery international Vol. 12; no. 1; pp. 34 - 37
• Main Authors: CUSICK, E, SPICER, R. D, BECK, J. M
• Format: Journal Article
• Language: English
• Published: Heidelberg Springer 1997; Berlin
• Subjects: Abdominal Muscles - abnormalities; Biological and medical sciences; Child, Preschool; Humans; Infant; Infant, Newborn; Intestinal Atresia - complications; Intestinal Atresia - mortality; Intestinal Atresia - surgery; Liver Failure - etiology; Male; Medical sciences; Parenteral Nutrition, Total - adverse effects; Prognosis; Retrospective Studies; Stomach, duodenum, intestine, rectum, anus; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Survival Analysis; Treatment Outcome; Human; Prognosis; Anatomical reconstruction; Result; Gastrochisis; Treatment; Malformation; Abdominal disease; Surgery; Disease of the small intestine; Atresia; Abdominal wall; Digestive diseases; Child
• ISSN: 0179-0358; 1437-9813
• DOI: 10.1007/BF01194799

A retrospective analysis of a series of 63 cases of gastroschisis managed over an 11-year period distinguished a single statistically significant prognostic factor. There were 6 (9.5%) deaths, of which 4 occurred in the 8 infants with small-bowel atresia/stenosis (P < 0.005, Fisher's exact test). One died at 48 h and the remaining 3 of liver disease related to total parenteral nutrition. Of the 4 survivors, 1 developed a late biliary stricture necessitating hepaticoenterostomy but is alive and well aged 4 years. The remaining 3, following initially prolonged hospitalisations and multiple operations, are alive and well after 2, 4 and 7 years. In 3 patients the atresia was not detected at the primary operation. The small number of cases of gastroschisis-associated small-bowel atresia seen in any one unit may conceal the importance of the problem, and limits experience in the approach to management.