Published online Nov 15, 2015. doi: 10.4291/wjgp.v6.i4.228
Peer-review started: June 6, 2015
First decision: August 10, 2015
Revised: October 12, 2015
Accepted: October 23, 2015
Article in press: October 27, 2015
Published online: November 15, 2015
AIM: To establish children born with gastroschisis (GS).
METHODS: We performed a retrospective study covering the period from January 2000 to December 2007. The following variables were analyzed for each child: Weight, sex, apgar, perforations, atresia, volvulus, bowel lenght, subjective description of perivisceritis, duration of parenteral nutrition, first nasogastric milk feeding, total milk feeding, necrotizing enterocolitis, average period of hospitalization and mortality. For statistical analysis, descriptive data are reported as mean ± standard deviation and median (range). The non parametric test of Mann-Whitney was used. The threshold for statistical significance was P < 0.05 (Two-Tailed).
RESULTS: Sixty-eight cases of GS were studied. We found nine cases of perforations, eight of volvulus, 12 of atresia and 49 children with subjective description of perivisceritis (72%). The mortality rate was 12% (eight deaths). Average duration of total parenteral nutrition was 56.7 d (8-950; median: 22), with five cases of necrotizing enterocolitis. Average length of hospitalization for 60 of our patients was 54.7 d (2-370; median: 25.5). The presence of intestinal atresia was the only factor correlated with prolonged parenteral nutrition, delayed total oral milk feeding and longer hospitalization.
CONCLUSION: In our study, intestinal atresia was our predictive factor of the severity of GS.
Core tip: Gastroschisis (GS) is defined as a full-thickness congenital abdominal wall defect usually situated on the right side of the umbilicus, with intestines protruding into the amniotic fluid without any protective membrane. The amniotic fluid creates an inflammation of the bowel wall, called perivisceritis. Associated with intestinal abnormalities are malrotation and a degree of short bowel: Volvulus, perforation and atresia may also be found. Our study shows that for babies born with GS, intestinal atresia is the only factor of prediction of the need for early and full enteral feeding, for its duration, and for the length of hospitalization.