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Clinical features

Authoring team

The characteristic clinical finding in babies born with gastroschisis is a full-thickness paraumbilical abdominal wall defect (to the right of the umbilicus) with the associated evisceration of the bowel. The abdominal wall defect tends to be approximately 4 cm in size.

There is no peritoneal sac so that antenatal evisceration of the abdominal content occurs through the abdominal wall defect throughout intrauterine life.

Amniotic fluid frequently irritates the exposed bowel wall causing a chemical peritonitis characterised by a thickened oedematous membrane which is occasionally exudative.

The exposed viscera

  • appears foreshortened.
  • covered with gelatinous exudates, matted together, and/or is oedematous due to its exposure to amniotic fluid and compression of the mesenteric blood supply at the defect (1)
  • nonrotation is normal.

Evisceration of the liver is rare but in females, the ovaries and fallopian tubes may be found outside the defect.

Reference:

  1. Hashish AAE, Elhalaby E. Evolution of management of gastroschisis. Annals of Pediatric Surgery 2011, 7:10–15

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