Gastroschisis and Omphalocele

Abstract

Gastroschisis is not usually complicated with other severe anomalies, and if the prolapsed intestine is not edematous, it should be reduced into the abdominal cavity and primary closure of the abdominal wall could be possible. But if the prolapsed intestine is very edematous because of prolonged stimuli by the amniotic fluid and congestion of the mesenteric veins, multistage closure of the abdominal wall is recommended. We recently use the wound retractor Alexis^R to construct silo. More recently sutureless closure of the abdominal wall is reported.

Omphalocele is often complicated with some severe congenital anomalies such as severe cardiac disease or chromosomal anomaly. If the hernia is very small, named as hernia into the umbilical cord, the abdominal wall is closed soon after birth. But if the hernia size is large and liver parenchyma prolapsed, the primary closure of the abdominal wall is impossible, and multistage closure should be chosen. Silo is first constructed using Alexis^R to cover the prolapsed organs, and within 7–10 days, silo is squeezing so as to put into the prolapsed organs into the abdominal cavity. Finally the abdominal wall is closed. Recently more severe cases of omphalocele have come to be saved because of the progress of the respiratory care.

The figures in this chapter are reprinted with permission from Standard Pediatric Operative Surgery (in Japanese), Medical View Co., Ltd., 2013, with the exception of occasional newly added figures that may appear.