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9 Cards in this Set

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  • Back
What's gastrochesis?
Gastroschisis refers to a full-thickness paraumbilical abdominal wall defect associated with evisceration of fetal intestine
What causes gastrochesis?
The defect in gastroschisis is secondary to a VASCULAR accident in the somatopleure and the ensuing disruption of a normally developing abdominal wall. This vascular injury results in a full thickness abdominal wall defect with herniation of small, and possibly large, bowel.
What does gastrochesis look like?
is a normally positioned umbilical cord insertion with an intestinal mass lacking a covering sac located to the right of midline
What is associated with gastrochesis?
gastroschisis is not usually associated with malformations outside of the gastrointestinal tract; however, additional gastrointestinal problems (eg, malrotation, atresia, stenosis) are present in 25 percent of cases because of underlying vascular impairment of the bowel and related adhesion formation
What's the best way to deliver a gastrochesis baby?
As with omphalocele, there is no clear evidence that mode of delivery alters outcome.
What's the immediate treatment for gastrochesis?
Neonatal fluid losses are 2.5 times that of a healthy newborn in the first 24 hours of life.
In the delivery room, it is important to wrap the bowel with sterile saline dressings covered with plastic wrap to preserve heat and minimize insensible fluid loss, insert an orogastric tube to decompress the stomach, place peripheral intravenous access to provide fluids and broad-spectrum antibiotics
What is the treatment for gastrochesis?
The abdominal wall is manually stretched and the bowel is replaced, taking care to avoid creating intraabdominal pressure that is too high. Primary closure is successful in 70 percent of cases.
What's a common problem after gastrochesis repair?
-Postoperatively, prolonged dismotility, which interferes with enteral feeding, is a common problem.
-Necrotizing enterocolitis is responsible for significant neonatal morbidity and has been reported to occur in up to 20 percent of cases [2]. Longterm gastrointestinal problems related to bowel adhesions or short gut syndrome have been reported, but are uncommon.
How can you detect this prenatally?
Elevated MS AFP - in abdominal wall defect and neural tube defects.