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Gastroschisis

by William J. Cochran, MD

Gastroschisis is protrusion of the abdominal viscera through a full-thickness abdominal wall defect, usually to the right of the umbilical cord insertion.

The estimated incidence is 1 in 2500 live births (more common than omphalocele). In gastroschisis, unlike omphalocele, there is no membranous covering over the intestine, which is markedly edematous and erythematous and is often enclosed in a fibrin mat. These findings indicate long-standing inflammation due to the intestine being directly exposed to amniotic fluid (ie, chemical peritonitis). Infants with gastroschisis have low incidence of associated congenital anomalies other than malrotation. As in omphalocele, gastroschisis can be detected by prenatal ultrasonography, and delivery should take place at a tertiary care center. Surgery is similar to that for omphalocele. It often takes several weeks before GI function recovers and oral feedings can be given; occasionally, infants have long-term problems caused by abnormal intestinal motility.

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