کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
4158552 | 1273813 | 2008 | 5 صفحه PDF | دانلود رایگان |

BackgroundIn infants with gastroschisis antenatal closure of the umbilical defect results in a proximal atresia with ischemia and/or volvulus of the extracorporeal midgut. It has been described as “closed gastroschisis” or “vanishing midgut.”MethodsA 10-year review of 219 gastroschisis patients identified 10 infants with this rare complication.ResultsIn these 10 infants, the extracorporeal midgut was invariably matted and fibrosed. In 3 cases, the midgut had completely “vanished.” In the remaining 7 cases, the remnant midgut was surgically reduced into the abdominal cavity with care not to compromise the diminutive vascular pedicle. Abdominal exploration was performed several weeks later to reestablish bowel continuity; 4 required an ostomy and 2 underwent a serial transverse enteroplasty. Mean residual length of salvaged small bowel was 79 cm with retention of the distal half of the colon. Eight infants survived the initial hospitalization, with a mean length of stay of 121 days and mean hospital charge of $287,094. Six of the 7 long-term survivors have been completely weaned off total parenteral nutrition.ConclusionA nihilistic attitude toward infants with closed gastroschisis may not be uniformly supported because in the majority of these infants' long-term independence from total parenteral nutrition was achieved.
Journal: Journal of Pediatric Surgery - Volume 43, Issue 6, June 2008, Pages 1006–1010