Comprehensive Developmental Mechanisms in Gastroschisis

Abstract

Introduction: The development of gastroschisis remains an area of controversy. Various theories have been proposed, but none has ever been supported by a thorough embryological study. Material and Methods: We herein report anatomical and microscopic observations of the developing abdominal wall and cord of embryos and fetuses, along with clinical features of gastroschisis. Results: It appears that the developing cord normally has two parts, a firm left-sided part formed by the vessels and urachus, and a thin right-sided pouch covering the intestinal loops (the ‘physiological umbilical hernia'), which could rupture, giving the basis of gastroschisis. Discussion: Gastroschisis could be the result of amniotic damage, possibly from some as yet unidentified toxin. Further bowel damage can be explained by the subsequent mesenteric injury.

Predicting Perinatal Outcome from Prenatal Ultrasound Characteristics in Pregnancies Complicated by Gastroschisis

“…In our cohort, we were not able to confirm the findings by Carnaghan et al [37], showing an increased predictive value when combining intra- and extra-abdominal loop assessment. It has been hypothesized that antenatal bowel dilatation is secondary to constriction at the defect site [38] and/or inflammatory changes of the intestinal bowel wall changes secondary to exposure to amniotic fluid constituents [28,39,40,41]. It remains to be elucidated whether IABD reflects both mechanisms and if early intervention based on this prenatal sign can, in fact, reverse bowel damage.…”

Gastroschisis in Europe – A Case‐malformed‐Control Study of Medication and Maternal Illness during Pregnancy as Risk Factors

“…Gastroschisis is a congenital anomaly where the small intestine, part of the large intestine and occasionally other abdominal organs protrude through a lateral defect in the ventral abdomen . The majority of cases are isolated anomalies .…”

A Case of Superior Sided Gastroschisis

“…1,2 While the exact etiopathogenesis of gastroschisis is still uncertain, it has been argued that a vascular compromise within the embryonic period may be responsible for the development of the abdominal wall defect. 7 Inadequate obliteration of the right umbilical vein or of the right omphalomesenteric artery could lead to either weakness or necrosis of the forming abdominal wall. 8,9 It is very interesting to note that left-sided cases are frequently associated with extra-digestive anomalies.…”