A case of vanishing gastroschisis with short bowel syndrome treated by total parenteral nutrition and intestinal lengthening procedures

Author:

Guanà Riccardo12ORCID,Marocco Lucia3,Garofalo Salvatore1,Zambaiti Elisa1ORCID,Pane Alessandro1,Scottoni Federico1,Fusaro Fabio4,Perucca Giulia5,Gennari Fabrizio1

Affiliation:

1. Pediatric Surgery Unit, University Hospital of Health and Science, Regina Margherita Children’s Hospital, Turin, Italy

2. Division of Pediatric General, Thoracic, Neonatal & Minimally Invasive Surgery, Regina Margherita Children’s Hospital, Turin, Italy

3. Post-graduate School of Pediatrics, Regina Margherita Children’s Hospital, University of Turin, Turin, Italy

4. Bambino Gesù Children’s Hospital, Rome, Italy

5. Pediatric Radiology Unit, Great Ormond Street Hospital, London, UK

Abstract

The diagnosis of vanishing gastroschisis is made when in the presence of a full-thickness intrauterine abdominal wall defect the eviscerated loops are incarcerated in the fascial interruption. Four types of vanishing gastroschisis are described (A–D). We report on the case of a newborn with a vanishing gastroschisis-D. Gastroschisis was diagnosed at the 19th week of gestation, confirmed at the 30th, when the herniated loops previously visible to the right of the funiculus were no longer visualized. At the 32nd week, delivery was induced. The neonate weighed 1600 g, and the abdomen was distended, free from skin defects. On surgical exploration, the jejunum was 13 cm in length, with a blind ending. The post-atretic intestine measured 22 cm. A jejunostomy and a colostomy were built. The child received total parenteral nutrition for 13 months due to short bowel syndrome and was then subjected to intestinal lengthening procedure when she was 18 months old. Vanishing gastroschisis is a rare entity with a worse prognosis of the “classic” gastroschisis.

Publisher

SAGE Publications

Subject

General Medicine

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