In the company of Medicine

Between the coversπŸ“š


In the company of Medicine :books: ☀):pill::syringe: ©2020

GASTROSCHISIS

  • Caused by vascular insult β†’ bowel herniation
  • 2 nd trimester USG β†’ >95% sensitive for abdominal wal defects and maternal serum AFP usually ↑ed
  • Gastroschisis β†’ bowel exposed to amniotic fluid β†’ inflammation and edema of bowel wall β†’ ↑ risk of complications (eg necrotizing enterocolitis, short bowel syndrome)
  • Dysmotility (ileus, delayed gastric emptying, intolerance to feeds)β€”occur in >50% cases and may prolong reliance on TPN - It is isolated defect in >90% cases
  • Rx: after delivery β†’ cover exposed bowel with sterile saline dressings and plastic wrap to minimize insensible heat and fluid losses β†’ Place nasogastric tube to decompress bowel and start on antibiotic therapy β†’ prompt surgical repair and can usually be accomplished in a single-stage closure.