Additional pediatric resources: GeneralPediatrics.com | PediatricEducation.org | SearchingPediatrics.com
Correlapaedia - a Correlative Encyclopedia of Pediatric Imaging, Surgery, and Pathology
Clinical History:
The patient was a newborn full term male with an anterior abdominal wall defect diagnosed via prenatal ultrasound.
Clinical Physical Exam:
A gastroschisis defect was present with the stomach, small bowel and appendix protruding out of the abdomen. Thin extremities with arthrogrypotic fourth finger contractures bilaterally were also noted.
Clinical Labs:
The patient had a normal AFP and chromosome survey.
Clinical Differential Diagnosis:
Gastroschisis
Imaging Findings:
A preoperative AP chest x-ray demonstrated gastroschisis with the bowel loops on the right side exterior to the baby.
Imaging Differential Diagnosis:
Gastroschisis
Operative Findings:
On the first day of life the defect was initially repaired. The stomach and small bowel were dilated due to there being colonic atresia just distal to the cecum. The distal colon was small in caliber. A silo for the abdominal contents was constructed using sterile silastic sheet material and Teflon mesh and sterile gauze and saran wrap. A gastrostomy and cecostomy were also placed.
Pathological Findings:
None
Final Diagnosis:
Gastroschisis, Colonic Atresia, Post-Op GI Dysmotility, Arthrogryposis
Follow-up and Prognosis:
The silo was progressively reduced, returning the abdominal viscera to the abdominal cavity. The patient's cecum was eventually reanastomosed to his colon. The patient had difficulty with his total parenteral nutrition (TPN), resulting in TPN induced liver failure. The patient also had persistent GI dysmotility.
Similar Cases:
Case 19,
Case 25,
Case 52
References:
Additional pediatric resources: GeneralPediatrics.com | PediatricEducation.org | SearchingPediatrics.com
Please send us comments by filling out our Comment Form.
All contents copyright © 1992-2023 Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D. and the authors. All rights reserved.
"Virtual Pediatric Hospital", the Virtual Pediatric Hospital logo, and "A digital library of pediatric information" are all Trademarks of Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D.
Virtual Pediatric Hospital is funded in whole by Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D. Advertising is not accepted.
Your personal information remains confidential and is not sold, leased, or given to any third party be they reliable or not.
The information contained in Virtual Pediatric Hospital is not a substitute for the medical care and advice of your physician. There may be variations in treatment that your physician may recommend based on individual facts and circumstances.
URL: http://www.virtualpediatrichospital.org/