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Gastroschisis
Roya Sohaey, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Definitions

              • Full-thickness paramedian abdominal wall defect with bowel evisceration and no covering membrane
                • Almost always right-sided defect
              • Classifications are postnatal (fetal findings are suggestive)
                • Simple gastroschisis (80-90%)
                  • Not associated with bowel complications
                  • No significant bowel dilation in fetus
                • Complex gastroschisis (CG) (11-28%)
                  • Bowel complications: Atresia, stenosis, volvulus, perforation, ischemia
                  • Key fetal feature is bowel distention
                • Abdominoschisis with herniated liver (2-16%)
                  • Extracorporeal liver seen during fetal ultrasound

            IMAGING

            • General Features

              • Ultrasonographic Findings

                • MR Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Gross Pathologic & Surgical Features

                          CLINICAL ISSUES

                          • Presentation

                            • Demographics

                              • Natural History & Prognosis

                                • Treatment

                                  DIAGNOSTIC CHECKLIST

                                  • Image Interpretation Pearls

                                    Selected References

                                    1. Revels JW et al: An algorithmic approach to complex fetal abdominal wall defects. AJR Am J Roentgenol. 214(1):218-31, 2020
                                    2. Sherer DM et al: Prenatal sonography of extracorporeal ductus venosus in association with large fetal gastroschisis. J Clin Ultrasound. 48(7):416-8, 2020
                                    3. Svetanoff WJ et al: Giant gastroschisis with complete liver herniation: a case report of two patients. Case Rep Surg. 2019:4136214, 2019
                                    4. Haddock C et al: Understanding gastroschisis and its clinical management: where are we? Expert Rev Gastroenterol Hepatol. 12(4):405-15, 2018
                                    5. Oakes MC et al: Advances in prenatal and perinatal diagnosis and management of gastroschisis. Semin Pediatr Surg. 27(5):289-99, 2018
                                    6. Victoria T et al: Fetal anterior abdominal wall defects: prenatal imaging by magnetic resonance imaging. Pediatr Radiol. 48(4):499-512, 2018
                                    7. Pakdaman R et al: Complex abdominal wall defects: appearances at prenatal imaging. Radiographics. 35(2):636-49, 2015
                                    8. Goetzinger KR et al: Sonographic predictors of postnatal bowel atresia in fetal gastroschisis. Ultrasound Obstet Gynecol. 43(4):420-5, 2014
                                    9. Lusk LA et al: Multi-institutional practice patterns and outcomes in uncomplicated gastroschisis: a report from the University of California Fetal Consortium (UCfC). J Pediatr Surg. 49(12):1782-6, 2014
                                    10. Overcash RT et al: Factors associated with gastroschisis outcomes. Obstet Gynecol. 124(3):551-7, 2014
                                    11. Grant NH et al: Elective preterm birth for fetal gastroschisis. Cochrane Database Syst Rev. 6:CD009394, 2013
                                    12. South AP et al: Metaanalysis of the prevalence of intrauterine fetal death in gastroschisis. Am J Obstet Gynecol. 209(2):114.e1-13, 2013
                                    13. Ajayi FA et al: Ultrasound prediction of growth abnormalities in fetuses with gastroschisis. J Matern Fetal Neonatal Med. 24(3):489-92, 2011
                                    14. Alfaraj MA et al: Does gastric dilation predict adverse perinatal or surgical outcome in fetuses with gastroschisis? Ultrasound Obstet Gynecol. 37(2):202-6, 2011
                                    15. Chaudhury P et al: Ultrasound prediction of birthweight and growth restriction in fetal gastroschisis. Am J Obstet Gynecol. 203(4):395, 2010
                                    16. Contro E et al: Prenatal ultrasound in the prediction of bowel obstruction in infants with gastroschisis. Ultrasound Obstet Gynecol. 35(6):702-7, 2010
                                    17. Frolov P et al: Clinical risk factors for gastroschisis and omphalocele in humans: a review of the literature. Pediatr Surg Int. 26(12):1135-48, 2010
                                    18. Garcia L et al: Bowel dilation as a predictor of adverse outcome in isolated fetal gastroschisis. Prenat Diagn. 30(10):964-9, 2010
                                    19. Holland AJ et al: Gastroschisis: an update. Pediatr Surg Int. 26(9):871-8, 2010
                                    20. Horton AL et al: Intrauterine growth patterns in fetal gastroschisis. Am J Perinatol. 27(3):211-7, 2010
                                    21. Huh NG et al: Prenatal intraabdominal bowel dilation is associated with postnatal gastrointestinal complications in fetuses with gastroschisis. Am J Obstet Gynecol. 202(4):396, 2010
                                    22. Kohl M et al: Familial recurrence of gastroschisis: literature review and data from the population-based birth registry "Mainz Model". J Pediatr Surg. 45(9):1907-12, 2010
                                    23. Kronfli R et al: Intestinal atresia in association with gastroschisis: a 26-year review. Pediatr Surg Int. 26(9):891-4, 2010
                                    24. Mears AL et al: Antenatal bowel dilatation in gastroschisis: a bad sign? Pediatr Surg Int. 26(6):581-8, 2010
                                    25. Mills JA et al: Perinatal predictors of outcome in gastroschisis. J Perinatol. 30(12):809-13, 2010
                                    26. Nicholas S et al: Estimation of fetal weight in fetuses with abdominal wall defects: comparison of 2 recent sonographic formulas to the Hadlock formula. J Ultrasound Med. 29(7):1069-74, 2010
                                    27. Owen A et al: Gastroschisis: a national cohort study to describe contemporary surgical strategies and outcomes. J Pediatr Surg. 45(9):1808-16, 2010
                                    28. Pachajoa H et al: Congenital arthrogryposis multiplex and gastroschisis in the same patient. Neurologia. 25(8):517-8, 2010
                                    29. Sadler TW et al: Examining the evidence for vascular pathogenesis of selected birth defects. Am J Med Genet A. 152A(10):2426-36, 2010
                                    30. Sadler TW: The embryologic origin of ventral body wall defects. Semin Pediatr Surg. 19(3):209-14, 2010
                                    31. Salomon LJ et al: The meaning of intraabdominal bowel dilation in fetuses with gastroschisis. Am J Obstet Gynecol. 203(6):e9-10; author reply e10, 2010
                                    Related Anatomy
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                                    Related Differential Diagnoses
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                                    References
                                    Tables

                                    Tables

                                    KEY FACTS

                                    • Terminology

                                      • Imaging

                                        • Top Differential Diagnoses

                                          • Pathology

                                            • Clinical Issues

                                              TERMINOLOGY

                                              • Definitions

                                                • Full-thickness paramedian abdominal wall defect with bowel evisceration and no covering membrane
                                                  • Almost always right-sided defect
                                                • Classifications are postnatal (fetal findings are suggestive)
                                                  • Simple gastroschisis (80-90%)
                                                    • Not associated with bowel complications
                                                    • No significant bowel dilation in fetus
                                                  • Complex gastroschisis (CG) (11-28%)
                                                    • Bowel complications: Atresia, stenosis, volvulus, perforation, ischemia
                                                    • Key fetal feature is bowel distention
                                                  • Abdominoschisis with herniated liver (2-16%)
                                                    • Extracorporeal liver seen during fetal ultrasound

                                              IMAGING

                                              • General Features

                                                • Ultrasonographic Findings

                                                  • MR Findings

                                                    • Imaging Recommendations

                                                      DIFFERENTIAL DIAGNOSIS

                                                        PATHOLOGY

                                                        • General Features

                                                          • Gross Pathologic & Surgical Features

                                                            CLINICAL ISSUES

                                                            • Presentation

                                                              • Demographics

                                                                • Natural History & Prognosis

                                                                  • Treatment

                                                                    DIAGNOSTIC CHECKLIST

                                                                    • Image Interpretation Pearls

                                                                      Selected References

                                                                      1. Revels JW et al: An algorithmic approach to complex fetal abdominal wall defects. AJR Am J Roentgenol. 214(1):218-31, 2020
                                                                      2. Sherer DM et al: Prenatal sonography of extracorporeal ductus venosus in association with large fetal gastroschisis. J Clin Ultrasound. 48(7):416-8, 2020
                                                                      3. Svetanoff WJ et al: Giant gastroschisis with complete liver herniation: a case report of two patients. Case Rep Surg. 2019:4136214, 2019
                                                                      4. Haddock C et al: Understanding gastroschisis and its clinical management: where are we? Expert Rev Gastroenterol Hepatol. 12(4):405-15, 2018
                                                                      5. Oakes MC et al: Advances in prenatal and perinatal diagnosis and management of gastroschisis. Semin Pediatr Surg. 27(5):289-99, 2018
                                                                      6. Victoria T et al: Fetal anterior abdominal wall defects: prenatal imaging by magnetic resonance imaging. Pediatr Radiol. 48(4):499-512, 2018
                                                                      7. Pakdaman R et al: Complex abdominal wall defects: appearances at prenatal imaging. Radiographics. 35(2):636-49, 2015
                                                                      8. Goetzinger KR et al: Sonographic predictors of postnatal bowel atresia in fetal gastroschisis. Ultrasound Obstet Gynecol. 43(4):420-5, 2014
                                                                      9. Lusk LA et al: Multi-institutional practice patterns and outcomes in uncomplicated gastroschisis: a report from the University of California Fetal Consortium (UCfC). J Pediatr Surg. 49(12):1782-6, 2014
                                                                      10. Overcash RT et al: Factors associated with gastroschisis outcomes. Obstet Gynecol. 124(3):551-7, 2014
                                                                      11. Grant NH et al: Elective preterm birth for fetal gastroschisis. Cochrane Database Syst Rev. 6:CD009394, 2013
                                                                      12. South AP et al: Metaanalysis of the prevalence of intrauterine fetal death in gastroschisis. Am J Obstet Gynecol. 209(2):114.e1-13, 2013
                                                                      13. Ajayi FA et al: Ultrasound prediction of growth abnormalities in fetuses with gastroschisis. J Matern Fetal Neonatal Med. 24(3):489-92, 2011
                                                                      14. Alfaraj MA et al: Does gastric dilation predict adverse perinatal or surgical outcome in fetuses with gastroschisis? Ultrasound Obstet Gynecol. 37(2):202-6, 2011
                                                                      15. Chaudhury P et al: Ultrasound prediction of birthweight and growth restriction in fetal gastroschisis. Am J Obstet Gynecol. 203(4):395, 2010
                                                                      16. Contro E et al: Prenatal ultrasound in the prediction of bowel obstruction in infants with gastroschisis. Ultrasound Obstet Gynecol. 35(6):702-7, 2010
                                                                      17. Frolov P et al: Clinical risk factors for gastroschisis and omphalocele in humans: a review of the literature. Pediatr Surg Int. 26(12):1135-48, 2010
                                                                      18. Garcia L et al: Bowel dilation as a predictor of adverse outcome in isolated fetal gastroschisis. Prenat Diagn. 30(10):964-9, 2010
                                                                      19. Holland AJ et al: Gastroschisis: an update. Pediatr Surg Int. 26(9):871-8, 2010
                                                                      20. Horton AL et al: Intrauterine growth patterns in fetal gastroschisis. Am J Perinatol. 27(3):211-7, 2010
                                                                      21. Huh NG et al: Prenatal intraabdominal bowel dilation is associated with postnatal gastrointestinal complications in fetuses with gastroschisis. Am J Obstet Gynecol. 202(4):396, 2010
                                                                      22. Kohl M et al: Familial recurrence of gastroschisis: literature review and data from the population-based birth registry "Mainz Model". J Pediatr Surg. 45(9):1907-12, 2010
                                                                      23. Kronfli R et al: Intestinal atresia in association with gastroschisis: a 26-year review. Pediatr Surg Int. 26(9):891-4, 2010
                                                                      24. Mears AL et al: Antenatal bowel dilatation in gastroschisis: a bad sign? Pediatr Surg Int. 26(6):581-8, 2010
                                                                      25. Mills JA et al: Perinatal predictors of outcome in gastroschisis. J Perinatol. 30(12):809-13, 2010
                                                                      26. Nicholas S et al: Estimation of fetal weight in fetuses with abdominal wall defects: comparison of 2 recent sonographic formulas to the Hadlock formula. J Ultrasound Med. 29(7):1069-74, 2010
                                                                      27. Owen A et al: Gastroschisis: a national cohort study to describe contemporary surgical strategies and outcomes. J Pediatr Surg. 45(9):1808-16, 2010
                                                                      28. Pachajoa H et al: Congenital arthrogryposis multiplex and gastroschisis in the same patient. Neurologia. 25(8):517-8, 2010
                                                                      29. Sadler TW et al: Examining the evidence for vascular pathogenesis of selected birth defects. Am J Med Genet A. 152A(10):2426-36, 2010
                                                                      30. Sadler TW: The embryologic origin of ventral body wall defects. Semin Pediatr Surg. 19(3):209-14, 2010
                                                                      31. Salomon LJ et al: The meaning of intraabdominal bowel dilation in fetuses with gastroschisis. Am J Obstet Gynecol. 203(6):e9-10; author reply e10, 2010