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Kargl, S; Wertaschnigg, D; Scharnreitner, I; Pumberger, W; Arzt, W.
[Closing gastroschisis: a distinct entity with high morbidity and mortality].
Ultraschall Med. 2012; 33(7): E46-E50. Doi: 10.1055/s-0031-1299479
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Kargl Simon
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Abstract:
We correlate severe bowel damage in gastroschisis to the rare intrauterine event of narrowing of the abdominal wall around the protruding intestines. We describe this "closing gastroschisis" as a distinct entity. Prenatal ultrasound findings as gastric or bowel dilation were compared to the postnatal findings in order to find markers for an early in utero diagnosis of closing gastroschisis. Early diagnosis could prompt timely delivery to save the compromised bowel and avoid short gut syndrome. We documented the pre- and postnatal course of our patients with gastroschisis from 2007 to 2009.  Closing gastroschisis was suspected antenatally and confirmed postnatally. We identified 5 out of 18 patients showing closure of the abdominal wall with varying degrees of bowel damage. Prenatal ultrasound findings were correlated to the postnatally confirmed extent of intestinal damage. We could not find consistent ultrasound markers for prenatal diagnosis of closing gastroschisis. In prenatal ultrasound three patients presented significant gastric dilation and then experienced severe courses postnatally due to segmental gut necrosis. One of these three died and the other two developed short gut syndrome. In one case progressive intraabdominal loop dilation with simultaneous shrinking of the extraabdominal loops occurred corresponding to closing gastroschisis with segmental midgut necrosis. Closing gastroschisis must be seen as a special form of gastroschisis. Extended intestinal damage is often life-threatening. In longitudinal observation dynamics of fetal ultrasound findings can lead to the diagnosis of closing gastroschisis. Progressive intraabdominal loop dilation is always highly suspicious and must lead to close follow-up and timely delivery. © Georg Thieme Verlag KG Stuttgart · New York.
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Abdominal Wall - diagnostic imaging
Abdominal Wall - embryology
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Follow-Up Studies -
Gastric Dilatation - diagnostic imaging
Gastric Dilatation - embryology
Gastric Dilatation - mortality
Gastroschisis - classification
Gastroschisis - diagnostic imaging
Gastroschisis - embryology
Gastroschisis - mortality
Humans -
Infant -
Infant, Newborn -
Intestinal Atresia - diagnostic imaging
Intestinal Atresia - embryology
Intestinal Atresia - mortality
Intestinal Atresia - pathology
Intestines - blood supply
Intestines - diagnostic imaging
Intestines - embryology
Ischemia - diagnostic imaging
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Ischemia - mortality
Male -
Necrosis -
Pregnancy -
Survival Rate -
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