Gastroschisis and the Risk of Short Bowel Syndrome: Outcomes and Counselling.

We present 4 cases with significant bowel shortening with very different ante- and postnatal presentations. Cases: Three of the cases demonstrated 'vanishing' gastroschisis with progressively worsening antenatal intra-abdominal bowel dilatation with no defect present at birth. The fourth case followed an uneventful course antenatally but developed SBS considered secondary to gastroschisis-related atresia and necrosis. All 4 cases were classified as having SBS and were enrolled within the paediatric Intestinal Rehabilitation Programme. This involves autologous gastrointestinal reconstruction following a period of bowel expansion with concomitant parenteral and enteral nutrition. Discussion: These cases demonstrate that the serious complication of significant bowel loss cannot always be anticipated. Early multidisciplinary discussion with the parents enables a shared understanding of potential outcomes. It can aid the recognition of 'vanishing' gastroschisis enabling expedient investigations and early intervention, minimising morbidity and maximising bowel length. © 2013 S. Karger AG, Basel. PMID: 24193105 [PubMed - as supplied by publisher]
Source: Neonatology - Category: Perinatology & Neonatology Authors: Tags: Neonatology Source Type: research