Gastroschisis

  • Etiology: anterior abdominal wall defect where defect is lateral to umbilicus
  • Imaging: multiple loops of bowel outside of abdominal cavity without an encasing sac
  • Treatment: reduced via silo
  • Complications: often have GI dysmotility for a year
  • Clinical: almost no associated congenital anomalies

Radiology Cases of Gastroschisis

CXR of gastroschisis
CXR shows multiple loops of bowel without an encasing sac wrapped in gauze outside of the abdomen to the right side of the patient. The abdominal cavity is small.
AXR of peripherally inserted central catheter / PICC in the spinal canal
AXR AP shows a left lower extremity PICC that does not follow the course of the iliac vein and whose tip projects at the level of L3 and that projects within the spinal canal on the lateral radiograph. The only gas within the abdomen is in the stomach while all of the small bowel is in a silo outside the abdomen.

Clinical Cases of Gastroschisis

Surgical image of gastroschisis
Surgical image shows the abdominal wall defect with stomach and small bowel protruding out of the abdomen, with no surrounding membranous sac.
Surgical image of gastroschisis
Surgical image shows an anterior abdominal wall defect with the small bowel protruding out of the abdomen, with no surrounding membranous sac. The small bowel loops are dilated. There was an atresia just distal to the cecum and the distal colon was small in caliber. A silo for the abdominal contents was constructed. A gastrostomy and cecostomy were also placed.
Clinical image of gastroschisis
Clinical image shows an anterior abdominal wall defect with stomach and small bowel exposed through an opening on the right side of the umbilicus. Note the absence of a peritoneal sac enclosing the abdominal contents.

Surgery Cases of Gastroschisis

Surgical image of gastroschisis
Surgical image shows a silo over loops of bowel not encased by a membranous sac that is being sequentially reduced several days after the initial operation. The small intestine has been almost completely reduced into the abdomen.
Surgical image of gastroschisis
Surgical image shows a prosthetic silo over loops of bowel not encased by a membranous sac that was created by sewing the silo to the fascia on either side of the incision. The silo was then wrapped in cotton gauze and sterile drapes. The patient underwent serial mesh tightening and on day of life eight underwent removal of the silo and final closure of the gastroschisis.