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Gastroschisis
A. Carlson Merrow, Jr., MD, FAAP
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Synonyms

                • Laparoschisis, celoschisis
              • Definitions

                • Gastroschisis: Congenital abdominal wall defect (AWD) lateral to normal umbilicus
                  • AWD almost always lies right of umbilical cord insertion
                  • Bowel herniates into amniotic cavity without covering membrane
                • Simple gastroschisis: Without bowel complications
                • Complex gastroschisis: Presence of bowel atresia, necrosis, &/or perforation in ~ 10-20% of cases

              IMAGING

              • General Features

                • Radiographic Findings

                  • Fluoroscopic Findings

                    • 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. Fisher SG et al: It is complex: predicting gastroschisis outcomes using prenatal imaging. J Surg Res. 258:381-8, 2021
                                          2. Dewberry LC et al: Examination of prenatal sonographic findings: intra-abdominal bowel dilation predicts poor gastroschisis outcomes. Fetal Diagn Ther. 47(3):245-50, 2020
                                          3. Granger J et al: Regional cluster of vanishing gastroschisis: a comparative study of antenatal and post-natal outcomes. J Paediatr Child Health. 56(3):420-5, 2020
                                          4. Revels JW et al: An algorithmic approach to complex fetal abdominal wall defects. AJR Am J Roentgenol. 214(1):218-31, 2020
                                          5. Williams SL et al: Feeding tolerance, intestinal motility, and superior mesenteric artery blood flow in infants with gastroschisis. Neonatology. 117(1):95-101, 2020
                                          6. Andrade WS et al: Fetal intra-abdominal bowel dilation in prediction of complex gastroschisis. Ultrasound Obstet Gynecol. 54(3):376-80, 2019
                                          7. Oakes MC et al: Advances in prenatal and perinatal diagnosis and management of gastroschisis. Semin Pediatr Surg. 27(5):289-99, 2018
                                          8. Victoria T et al: Fetal anterior abdominal wall defects: prenatal imaging by magnetic resonance imaging. Pediatr Radiol. 48(4):499-512, 2018
                                          9. Skarsgard ED: Management of gastroschisis. Curr Opin Pediatr. 28(3): 363-9, 2016
                                          10. Abdelhafeez AH et al: The risk of volvulus in abdominal wall defects. J Pediatr Surg. 50(4):570-2, 2015
                                          11. D'Antonio F et al: Prenatal risk factors and outcomes in gastroschisis: a meta-analysis. Pediatrics. 136(1):e159-69, 2015
                                          12. Bergholz R et al: Complex gastroschisis is a different entity to simple gastroschisis affecting morbidity and mortality-a systematic review and meta-analysis. J Pediatr Surg. 49(10):1527-32, 2014
                                          13. Page R et al: Gastroschisis: antenatal sonographic predictors of adverse neonatal outcome. J Pregnancy. 2014:239406, 2014
                                          14. Brugger PC et al: Development of gastroschisis as seen by magnetic resonance imaging. Ultrasound Obstet Gynecol. 37(4):463-70, 2011
                                          15. Ruano R et al: The association of gastroschisis with other congenital anomalies: how important is it? Prenat Diagn. 31(4):347-50, 2011
                                          16. 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
                                          17. 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
                                          18. Mears AL et al: Antenatal bowel dilatation in gastroschisis: a bad sign? Pediatr Surg Int. 26(6):581-8, 2010
                                          19. Houben C et al: Closing gastroschisis: diagnosis, management, and outcomes. J Pediatr Surg. 44(2):343-7, 2009
                                          20. Lansdale N et al: Staged reduction of gastroschisis using preformed silos: practicalities and problems. J Pediatr Surg. 44(11):2126-9, 2009
                                          21. van Eijck FC et al: The incidence and morbidity of adhesions after treatment of neonates with gastroschisis and omphalocele: a 30-year review. J Pediatr Surg. 43(3):479-83, 2008
                                          22. Arnold MA et al: Risk stratification of 4344 patients with gastroschisis into simple and complex categories. J Pediatr Surg. 42(9):1520-5, 2007
                                          23. Beaudoin S et al: Gastroesophageal reflux in neonates with congenital abdominal wall defect. Eur J Pediatr Surg. 5(6):323-6, 1995
                                          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

                                                    • Diagnostic Checklist

                                                      TERMINOLOGY

                                                      • Synonyms

                                                        • Laparoschisis, celoschisis
                                                      • Definitions

                                                        • Gastroschisis: Congenital abdominal wall defect (AWD) lateral to normal umbilicus
                                                          • AWD almost always lies right of umbilical cord insertion
                                                          • Bowel herniates into amniotic cavity without covering membrane
                                                        • Simple gastroschisis: Without bowel complications
                                                        • Complex gastroschisis: Presence of bowel atresia, necrosis, &/or perforation in ~ 10-20% of cases

                                                      IMAGING

                                                      • General Features

                                                        • Radiographic Findings

                                                          • Fluoroscopic Findings

                                                            • 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. Fisher SG et al: It is complex: predicting gastroschisis outcomes using prenatal imaging. J Surg Res. 258:381-8, 2021
                                                                                  2. Dewberry LC et al: Examination of prenatal sonographic findings: intra-abdominal bowel dilation predicts poor gastroschisis outcomes. Fetal Diagn Ther. 47(3):245-50, 2020
                                                                                  3. Granger J et al: Regional cluster of vanishing gastroschisis: a comparative study of antenatal and post-natal outcomes. J Paediatr Child Health. 56(3):420-5, 2020
                                                                                  4. Revels JW et al: An algorithmic approach to complex fetal abdominal wall defects. AJR Am J Roentgenol. 214(1):218-31, 2020
                                                                                  5. Williams SL et al: Feeding tolerance, intestinal motility, and superior mesenteric artery blood flow in infants with gastroschisis. Neonatology. 117(1):95-101, 2020
                                                                                  6. Andrade WS et al: Fetal intra-abdominal bowel dilation in prediction of complex gastroschisis. Ultrasound Obstet Gynecol. 54(3):376-80, 2019
                                                                                  7. Oakes MC et al: Advances in prenatal and perinatal diagnosis and management of gastroschisis. Semin Pediatr Surg. 27(5):289-99, 2018
                                                                                  8. Victoria T et al: Fetal anterior abdominal wall defects: prenatal imaging by magnetic resonance imaging. Pediatr Radiol. 48(4):499-512, 2018
                                                                                  9. Skarsgard ED: Management of gastroschisis. Curr Opin Pediatr. 28(3): 363-9, 2016
                                                                                  10. Abdelhafeez AH et al: The risk of volvulus in abdominal wall defects. J Pediatr Surg. 50(4):570-2, 2015
                                                                                  11. D'Antonio F et al: Prenatal risk factors and outcomes in gastroschisis: a meta-analysis. Pediatrics. 136(1):e159-69, 2015
                                                                                  12. Bergholz R et al: Complex gastroschisis is a different entity to simple gastroschisis affecting morbidity and mortality-a systematic review and meta-analysis. J Pediatr Surg. 49(10):1527-32, 2014
                                                                                  13. Page R et al: Gastroschisis: antenatal sonographic predictors of adverse neonatal outcome. J Pregnancy. 2014:239406, 2014
                                                                                  14. Brugger PC et al: Development of gastroschisis as seen by magnetic resonance imaging. Ultrasound Obstet Gynecol. 37(4):463-70, 2011
                                                                                  15. Ruano R et al: The association of gastroschisis with other congenital anomalies: how important is it? Prenat Diagn. 31(4):347-50, 2011
                                                                                  16. 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
                                                                                  17. 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
                                                                                  18. Mears AL et al: Antenatal bowel dilatation in gastroschisis: a bad sign? Pediatr Surg Int. 26(6):581-8, 2010
                                                                                  19. Houben C et al: Closing gastroschisis: diagnosis, management, and outcomes. J Pediatr Surg. 44(2):343-7, 2009
                                                                                  20. Lansdale N et al: Staged reduction of gastroschisis using preformed silos: practicalities and problems. J Pediatr Surg. 44(11):2126-9, 2009
                                                                                  21. van Eijck FC et al: The incidence and morbidity of adhesions after treatment of neonates with gastroschisis and omphalocele: a 30-year review. J Pediatr Surg. 43(3):479-83, 2008
                                                                                  22. Arnold MA et al: Risk stratification of 4344 patients with gastroschisis into simple and complex categories. J Pediatr Surg. 42(9):1520-5, 2007
                                                                                  23. Beaudoin S et al: Gastroesophageal reflux in neonates with congenital abdominal wall defect. Eur J Pediatr Surg. 5(6):323-6, 1995