Gastroschisis: Case Report from Hospital Escuela Universitario

Abstract

Introduction: Gastroschisis is a congenital malformation characterized by visceral herniation through a defect of the abdominal wall. It is commonly located to the right of the umbilical cord with visceral protrusion mainly of the distal ileum, stomach and liver, and it is not covered by a protective membrane. Gastroschisis prevalence is 0.5-7 per 10,000 live births, with an average of 1/2700 births. The highest prevalence of cases with gastroschisis occurs in young mothers <20 years and poor nutritional status. Case Description: This case is about an 18-year-old patient on her first pregnancy, with obstetric history of poor prenatal care. Two ultrasounds were performed during this pregnancy at a public hospital which did not report any alterations. At 38 weeks one day, the patient was born by c-section and was diagnosed with gastroschisis. Three hours later, the newborn was admitted at Hospital Escuela Universitario where a plastic silo was placed and later transferred to intermediate care unit. Twenty tree days later the abdominal wall defect was closed. She is currently stable, with reduced gastrointestinal motility, draining 50-60 cc daily by nasogastric tube, and receiving total parenteral nutrition. Discussion: Early recognition of this pathology is essential to prevent the development of fatal complications. It allows the consideration of different therapeutic-surgical approaches to achieve a higher survival rate for the newborn, especially in areas of high prevalence like ours, with a media of 17 cases per year with a low life expectancy of 47%