What is a Gastroschisis? – Causes, Complications, Life expectancy

What is a Gastroschisis? 

The surgical technique known as gastroschisis repair is performed on infants to correct a birth abnormality known as gastroschisis, which results in an opening in the skin and muscles that cover the abdomen region (abdominal wall). The intestines as well as other organs protrude through the hole. The procedure aims to repair the deficiency by re-inserting the organs into the baby’s abdomen. The damage is sometimes fixed soon after the birth of the child. 

The baby’s intestines emerge from the body through a hole near the belly button due to gastroschisis, an abnormality of the abdominal (belly) wall. The hole can be tiny or huge, and the baby’s stomach and liver will further be outside its body. Gastroschisis mostly manifests itself early in pregnancy. The incision is most frequently made on the right side of the abdominal button. 

Gastroschisis Causes

The precise cause of gastroschisis is still not determined; nevertheless, there are several hypothesized research that supports its pathogenesis. There are no congenital abnormalities associated with this herniation condition affecting the gastrointestinal tract.

If a woman gives birth to a baby with gastroschisis, it doesn’t mean that every baby she gives birth to after that also develops the same problem. Gastroschisis is associated with a higher amount of maternal serum alpha-fetoprotein.

Incomplete fusion can cause damage by allowing abdominal contents to protrude freely through the tiny gap in the abdominal wall. This intestinal hernia is located on the right side of the umbilicus, and it passes the rectus muscle.

What is a Gastroschisis? - Causes, Complications, Life expectancy

10 to 20% of fetuses diagnosed with gastroschisis have extensive damage to the intestine. This damage greatly affects the course of their condition after delivery and, in rare cases, can be fatal. These infants frequently require multiple operations to restore the intestine to the belly via a plastic silo and ultimately to close the abdominal wall. When the bowel is badly injured, it sometimes necessitates a partial or complete resection.

In extreme circumstances, insufficient bowel can often exist to allow for food absorption. The most badly affected babies often die, while others may develop “short bowel syndrome.” 

Gastroschisis Complications

Most children with gastroschisis have problems like slow growth, acid reflux that can cause them to throw up often, and poor absorption. This normally improves over time, except for children with Short Colon Syndrome due to bowel loss. 

Surgery is required to reintroduce the baby’s organs. Surgery also closes the opening at their belly button, preventing their organs from leaking outside their body.

There are two different forms of surgery to repair the abdominal wall and reposition the baby’s organs if they are protruding from the body:

Surgery to reposition the baby’s organs within the abdominal cavity and close the abdominal wall defect is called primary repair, and it is performed as soon as feasible after birth.

If this gastroschisis is more severe, the baby’s surgeon mostly executes the staged repair. 

The baby’s exposed organs are placed in a plastic pouch known as a silo by the baby’s surgeon from the moment the baby is born until the time that the baby undergoes surgery to repair gastroschisis. This mostly protects the organs from infection, dehydration, and injury.

After the initial operation to replace the baby’s organs, more surgery is required to restore the baby’s abdominal muscles or intestines.

There is a possibility of problems following gastroschisis surgery. Common problems following surgery include:

  • Infection at the location of surgery.
  • Trouble eating.
  • It is essential to place an intravenous (IV) line in the infant’s vein or a nasogastric tube, which is a tube that passes through the baby’s nose, down the esophagus, and into their stomach until the baby can start eating normally again. Intestinal developmental issues can affect up to 25% of infants born with gastroschisis.

Gastroschisis Life Expectancy

Overall, the prognosis for infants born with this disease is excellent. The current survival rate ranges from approximately 90% to 95%, with the majority of fatalities occurring in individuals who have suffered sepsis, catastrophic bowel loss, and long-term problems associated with short bowel syndrome.

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