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Gastroschisis Treatment

Gastroschisis is a type of hernia in which the intestine of a newborn infant protrudes through a defect in the umbilical cord. The problem can be detected before birth with frequent monitoring of the fetus via a prenatal ultrasonography while measuring amniotic fluid levels, an excess of which may indicate gastroschisis. Treatment involves immediate surgery after birth and intravenous nutrients to help prevent infection.

  1. Treatment

    • The only method of properly treating gastroschisis is with immediate surgery following birth. Repairing the defect involves returning the exposed intestine to the abdomen and immediately closing up the abdominal wall. The repair can be done immediately after birth or in stages. If done immediately, only one operation is necessary; if done in stages, the exposed intestine is placed in a protective covering and the baby is taken to the neonatal intensive care unit. Once there, the intestine is placed in a silastic sheeting known as a "silo," which is gradually reduced until the intestines are lined up with the skin. The exposed area is then surgically repaired. The method of repair used is dependent on the condition of the exposed intestine after birth.

    Recovery

    • Feeding is done gradually, beginning intravenously to allow adequate recovery time. As bowel function begins to return, the evidence of which is found in the first bowel movement, nutrients supplied via a naso-gastric, or NG, tube are given in conjunction with intravenous feeding. Over time, oral consumption of food is introduced.

      During recovery, the mother is encouraged to pump breast milk and freeze it, wherein it is supplied to the infant through the NG tube. Additional supplements may include formulas such as total parenteral nutrition, which includes all the necessary items for good health.

      The infant will be ready to return home when she can tolerated oral feeding and has adequate weight gain, which is typically between six and twelve weeks. The recovery time depends on the severity of the symptoms. Additional surgeries may be necessary, especially if the bowel has become narrower. This affects about 10 percent of infants with gastroschisis.

    Prognosis

    • If caught early and if the abdominal cavity of the newborn is big enough to accommodate the exposed intestines, the chances of a complete recovery are high. Should the abdominal cavity be too small, additional surgeries may be necessary, increasing the likelihood of complications.

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