Iberoamerican Journal of Medicine
https://iberoamjmed.com/article/doi/10.5281/zenodo.3723072
Iberoamerican Journal of Medicine
Case Report

Giant gastroschisis with complete gastric herniation: A case report and review of the literature

Bamidele Johnson Alegbeleye

Downloads: 0
Views: 929

Abstract

Introduction: We report a case of gastroschisis seen in our center, highlighting the rarity of this clinical entity. The author equally reviewed the existing literature covering the epidemiology, etiopathogenesis, management options, and outcomes of gastroschisis in low-income countries in sub-Saharan Africa and compares the reports with middle-income and high-income countries across the world.
Case presentation: A preterm female neonate with a clinical diagnosis of gastroschisis at a primary care center was referred to the Neonatology Service of our tertiary care institution. She received optimal resuscitation and interdisciplinary management. Besides, the baby underwent an initial covering with an improvised silo bag of exposed bowel with unfavorable outcomes.
Conclusion: The specific etiological factors for gastroschisis are yet to be established. The condition is considered a multifactorial disease. More frequently than ever, it's becoming easy to make prenatal diagnosis utilizing ultrasonography with high yield. Gastroschisis is a low-prevalence disease with an excellent prognosis if initial management is adequate. Interestingly, the condition requires highly skilled personnel of both specialized and primary care. Once the clinicians are well equipped, they can readily ensure correct initial management. Besides, the patient can equally benefit from an appropriate and timely referral to tertiary care centers to avoid future complications.

Keywords

Gastroschisis; Congenital anomaly; Anterior abdominal wall defects; Low-resource setting

References

1. Yılmaz J, İnanç I, İnan M. A case report: Gastroschisis. TMSJ. 2016;3(1):22-5.
2. Stoll C, Alembik Y, Dott B, Roth MP. Risk factors in congenital abdominal wall defect (omphalocele and gastroschisis): a study in a series of 265,858 consecutive births. Ann Genet. 2001;44(4):201-8. doi: 10.1016/s0003-3995(01)01094-2.
3. Moore TC, Stokes GE. Gastroschisis: report of two cases treated by a modification of the gross operation for omphalocele. Surgery. 1953;33(1):112-20.
4. Tan KH, Kilby MD, Whittle MJ, Beattie BR, Booth IW, Botting BJ. Congenital anterior abdominal wall defects in England and Wales 1987–93: retrospective analysis of OPCS data. BMJ. 1996;313(7062):903-6. doi: 10.1136/bmj.313.7062.903.
5. Hoyme HE, Jones MC, Jones KL. Gastroschisis: Abdominal wall disruption secondary to early gestational interruption of the omphalomesenteric artery. Semin Perinatol. 1983;7:294-8.
6. Erikci VS, Mert M, Özdemir T, Köylüoğlu G. Gastroschisis in a Premature Infant: A Case Report and Review of Literature. EC Paediatrics. 2018;7(5):400-5.
7. Schwartz MZ. Gastroschisis pediatric surgery. In: Puri P, Höllwarth M, editors. Berlin: Spring-Verlag; 2006:161.
8. Holland AJA, Walker K, Badawi N. Gastroschisis: an update. Pediatric Surgery International. 2010;26(9):871-8. doi: 10.1007/s00383-010-2679-1.
9. Rittler M, Campana H, Ermini ML, Gili JA, Poletta FA, Pawluk MA, et al. Gastroschisis and young mothers: what makes them different from other mothers of the same age? Birth Defects Res A Clin Mol Teratol. 2015;103(6):536-43. doi: 10.1002/bdra.23374.
10. Swift RI, Singh MP, Ziderman DA, Silverman M, Elder MA, Elder MG. A new regime in the management of gastroschisis. J Pediatr Surg. 1992;27(1):61-3. doi: 10.1016/0022-3468(92)90106-h.
11. Driver CP, Bruce J, Bianchi A, Doig CM, Dickson AP, Bowen J. The contemporary outcome of gastroschisis. J Pediatr Surg. 2000;35(12):1719-23. doi: 10.1053/jpsu.2000.19221.
12. Vegunta RK, Wallace LJ, Leonardi MR, Gross TL, Renfroe Y, Marshall JS, et al. Perinatal management of gastroschisis: analysis of a newly established clinical pathway. J Pediatr Surg. 2005;40(3):528-34. doi: 10.1016/j.jpedsurg.2004.11.037.
13. Ibarra-Calderón RA, Gutiérrez-Montufar OO, Saavedra-Torres JS, Zúñiga Cerón LFZ. Gastroschisis: Case Report and Management in Primary Care Services. Case Reports. 2018;4(1):10-8. doi: http://dx.doi.org/10.15446/cr.v4n1.65326.
14. Frolov P, Alali J, Klein MD. Clinical risk factors for gastroschisis and omphalocele in humans: a review of the literature. Pediatr Surg Int. 2010; 26(12):1135-48. doi: 10.1007/s00383-010-2701-7.
15. Ionescu S, Mocanu M, Andrei B, Bunea B, Carstoveanu C, Gurita A, et al. Differential diagnosis of abdominal wall defects - omphalocele versus gastroschisis. Chirurgia (Bucur). 2014;109(1):7-14.
16. Van Dorp DR, Malleis JM, Sullivan BP, Klein MD. Teratogens inducing congenital abdominal Wall deffects in animal models. Pediatr Surg Int. 2010; 26(2):127-39. doi: 10.1007/s00383-009-2482-z.
17. Tassin M, Benachi A. Diagnosis of abdominal wall defects in the first trimester. Curr Opin Obstet Gynecol. 2014;26(2):104-9. doi: 10.1097/GCO.0000000000000053.
18. Page R, Ferraro ZM, Moretti F, Kee-Fung KF. Gastroschisis: Antenatal sonographic predictors of adverse neonatal outcome. J Pregnancy. 2014;2014:239406. doi: 10.1155/2014/239406.
19. Waller SA, Paul K, Peterson SE, Hitti JE. Agricultural-related chemical exposures, season of conception, and risk of gastroschisis in Washington State. Am J Obstet Gynecol. 2010;202(3):241.e1-6. doi: 10.1016/j.ajog.2010.01.023.
20. Agopian AJ, Langlois PH, Cai Y, Canfield MA, Lupo PJ. Maternal residential atrazine exposure and gastroschisis by maternal age. Matern Child Health J. 2013;17(10):1768-75. doi: 10.1007/s10995-012-1196-3.
21. Torres US, Portela-Oliveira E, Braga Fdel C, Wemer H, Daltro PA, Souza AS. When clossure fails: What the radiologist needs to know about the embryology, anatomy, and prenatal imaging of ventral body wall defects. Semin Ultrasound CT MR. 2015;36(6):522-36. doi: 10.1053/j.sult.2015.01.001.
22. Zani A, Ruttenstock E, Davenport M, Ade-Ajayi N. Is there unity in Europe? First survey of EUPSA delegates on the management of gastroschisis. Eur J Pediatr Surg. 2013;23:19-24. doi: 10.1055/s-0032-1326954.
23. Wright NJ, Zani A, Ade-Ajayi N. Epidemiology, management and outcome of gastroschisis in Sub-Saharan Africa: Results of an international survey. Afr J Paediatr Surg. 2015;12:1-6. doi: 10.4103/0189-6725.150924.
24. Ross AR, Eaton S, Zani A, Ade-Ajayi N, Pierro A, Hall NJ. The role of preformed silos in the management of infants with gastroschisis: a systematic review and meta-analysis. Pediatr Surg Int. 2015;31:473-83. doi: 10.1007/s00383-015-3691-2.
25. Pastor AC, Phillips JD, Fenton SJ, Meyers RL, Lamm AW, Raval MV, et al. Routine use of a SILASTIC spring-loaded silo for infants with gastroschisis: a multicenter randomized controlled trial. J Pediatr Surg. 2008;43(10):1807-12. doi: 10.1016/j.jpedsurg.2008.04.003.
26. Bösenberg AT. Neonatal anesthesia with limited resources. Paediatr Anaesth 2014;24(1):98-105. doi: 10.1111/pan.12291.
27. Wright, NJ, Langer M, Norman ICF, Akhbari M, Wafford QE, Ade-Ajayi N, et al. Improving outcomes for neonates with gastroschisis in low-income and middle-income countries: a systematic review protocol. BMJ Paediatrics Open 2018;2(1):e000392. doi: 10.1136/bmjpo-2018-000392.
28. World Bank. World Bank Country and Lending Groups. 2018 https://datahelpdesk. worldbank. org/ knowledgebase/ articles/ 906519- world- bank- country- and- lending- groups (Accessed 16 Feb 2020).
29. Morazán AFD, Andrade DSB, Torres SJV, Zelaya WPB, Izaguirre REM, Molina FAL, et al. Non-viable Neonatal Gastroschisis: Case Report. J Clin Epigenet. 2017;3:2. doi: 10.21767/2472-1158.100049.
30. Herrera Nazer J, Essedin Karochan L, Ovalle Cifuentes L. Gastrosquisis: ¿Una pandemia con tasas en aumento? Experiencia del estudio colaborativo latinoamericano de malformaciones congénitas (ECLAMC) en Chile. Período 1982-2014. Rev chil pediatr. 2016;87(5):380-6. doi http://dx.doi.org/10.1016/j.rchipe.2016.06.003.
31. Serrano Monferrer A, Benet Montesinos L, Sanjuan Diaz R. Obstetric management of gastroschisis in a gestation of 26 weeks. Prog Obstet Ginecol. 2011;54:176-9.
32. Rasmussen SA, Frías JL. Non-genetic risk factors for gastroschisis. Am J Med Genet C Semin Med Genet. 2008; 148C(3):199-212. doi: 10.1002/ajmg.c.30175.
33. López-Valdéz JA, Castro-Cóyotl DM, Venegas-Vega CA. Nuevas hipótesis embriológicas, genética y epidemiología de la gastrosquisis. Bol Med Hosp. Infant Mex. 2011;68(3):245-52.
34. Jones KL, Benirschke K, Chambers CD. Gastroschisis: etiology and developmental pathogenesis. Clin Genet. 2009;75(4):322-5. doi: 10.1111/j.1399-0004.2009.01164.x.
35. Stevenson RE, Rogers RC, Chandler JC, Gauderer MW, Hunter AG. Escape of the yolk sac: a hypothesis to explain the embryogenesis of gastroschisis. Clin Genet. 2009;75(4):326-33. doi: 10.1111/j.1399-0004.2008.01142.x.
36. Radulescu M, Coriolan-Ulmeanu E, Nedelea M, Comsa A. Diagnosticul ecografic prenatal al gastroschizisului. Revista Romana de Pediatrie. 2012;61(4):344-8.
37. Gamba P, Midrio P. Abdominal wall defects: prenatal diagnosis, newborn management, and long-term outcomes. Semin Pediatr Surg. 2014;23(5):283-90. doi: 10.1053/j.sempedsurg.2014.09.009.
38. Wright N, Abantanga F, Amoah M, Appeadu-Mensah W, Bokhary Z, Bvulani B, et al. Developing and implementing an interventional bundle to reduce mortality from gastroschisis in low-resource settings Wellcome Open Res. 2019;4:46. doi: 10.12688/wellcomeopenres.15113.1.
39. Fillingham A, Rankin J. Prevalence, prenatal diagnosis and survival of gastroschisis. Prenatal Diagnosis. 2008;28(13):1232-7. doi: 10.1002/pd.2153.
40. Di Lorenzo M, Yazbeck S, Ducharme JC. Gastroschisis: a 15-year experience. J Pediatr Surg. 1987;22(8):710-2. doi: 10.1016/s0022-3468(87)80610-3.
41. Eurenius K, Axelsson O. Outcome for fetuses with abdominal wall defects detected by routine second trimester ultrasound. Acta Obstet Gynecol Scand. 1994;73:25-9. doi: https://doi.org/10.3109/00016349409013388.
42. Werler MM, Mitchell AA, Shapiro S. First trimester maternal medication use in relation to gastroschisis. Teratology. 1992; 45(4):361-7. doi: 10.1002/tera.1420450407.


Submitted date:
03/16/2020

Reviewed date:
03/19/2020

Accepted date:
03/21/2020

Publication date:
03/21/2020

5e760cd40e882509534778f4 iberoamericanjm Articles
Links & Downloads

Iberoam J Med

Share this page
Page Sections