Gastroschisis: Symptoms, Causes, Treatment

What are the symptoms of gastroschisis?

Gastroschisis is a birth defect where a baby’s intestines stick outside of the body through a hole beside the belly button. Symptoms can vary, but typically include:

1. Intestines outside the body: The most obvious symptom is the presence of intestines (and sometimes other organs) outside the baby’s body, usually to the right side of the belly button.
2. No protective sac: Unlike some similar conditions, like omphalocele, gastroschisis does not involve a protective sac covering the exposed organs.
3. Other associated defects: Sometimes, other birth defects may be present, such as intestinal atresia (a blockage in the intestines), and these can cause additional symptoms.
4. Complications: Babies with gastroschisis may develop complications such as infection, difficulty breathing, and problems with feeding and digestion.

The outlook for babies with gastroschisis is generally good with prompt treatment, although the extent of the defect and any associated conditions can affect the prognosis.

What are the causes of gastroschisis?

The exact cause of gastroschisis is not entirely understood, but it is believed to be multifactorial, meaning that several factors may contribute to its development. Some possible factors include:

1. Genetics: There may be a genetic component to gastroschisis, as it has been observed to occur more frequently in babies born to younger mothers.
2. Environmental factors: Certain environmental factors, such as exposure to certain chemicals or toxins, may play a role in the development of gastroschisis, although specific causative agents have not been definitively identified.
3. Vascular disruption: Some researchers believe that gastroschisis may result from a disruption in the blood supply to the abdominal wall during fetal development, leading to the defect.
4. Maternal factors: Certain maternal factors, such as smoking, drug use, or certain medications, may increase the risk of gastroschisis in the baby.
5. Nutritional factors: Poor maternal nutrition or inadequate prenatal care may also be associated with an increased risk of gastroschisis.

It’s important to note that while these factors may increase the risk of gastroschisis, the condition can still occur in babies without any known risk factors.

How is the diagnosis of gastroschisis made?

Gastroschisis is often diagnosed before birth during a prenatal ultrasound. The diagnosis is typically confirmed by the presence of the baby’s intestines (and sometimes other organs) outside the abdomen, usually to the right side of the belly button. Unlike omphalocele, there is usually no protective sac covering the exposed organs in gastroschisis.

After birth, the diagnosis is usually obvious based on the appearance of the baby’s abdomen. Additional imaging studies, such as an abdominal X-ray or ultrasound, may be done to further evaluate the extent of the condition and to check for any associated abnormalities or complications.

In some cases, gastroschisis may not be detected until after birth if the defect is small or if the intestines are not visibly protruding. In these cases, symptoms such as abdominal swelling, difficulty feeding, and failure to pass stool may prompt further evaluation and diagnosis.

What is the treatment for gastroschisis?

The primary treatment for gastroschisis is surgery, which is usually performed shortly after birth. The goals of surgery are to place the intestines and other organs back inside the abdomen and to repair the opening in the abdominal wall.

The specific surgical approach may vary depending on the size of the defect and the condition of the intestines. In some cases, the intestines can be placed back inside the abdomen and the opening in the abdominal wall can be closed immediately. However, in other cases where the defect is larger or the intestines are damaged, a staged approach may be necessary. This may involve placing the intestines in a protective silo (a type of bag) and gradually reducing them back into the abdomen over a period of days to weeks before closing the abdominal wall.

After surgery, the baby will require close monitoring in the neonatal intensive care unit (NICU). They may need assistance with breathing, intravenous fluids, and careful monitoring of their bowel function. Feeding may need to be initiated gradually, starting with intravenous nutrition and then transitioning to feeding by mouth or through a feeding tube.

The outlook for babies with gastroschisis is generally good with prompt surgical treatment. However, the long-term outlook can depend on the extent of the defect, any associated complications, and whether there are any other underlying health issues present. Regular follow-up with a pediatric surgeon and other specialists may be needed to monitor the baby’s growth and development.