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By William J. Cochran, MD, Geisinger Clinic, Danville, PA

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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 (10%) 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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