Gastroschisis and Omphalocele An Eight-year Review

Abstract

Until recently confusion has existed concerning the clinical features and surgical treatment of gastroschisis and omphalocele. Since 1971 75 infants with these abdominal wall defects have been treated at our institution. Significant differences (p equal to 0.001 in all instances) were noted between the two diseases. Gastroschisis occurred twice as often as omphalocele and is increasing in frequency. Prematurity was commonly seen with gastroschisis (65%). While the overall incidence of malformations associated with gastroschisis was low (23%), the vast majority of the additional malformations were jejunoileal or colonic atresias. The mortality rate was 12.7% among gastroschisis patients, with only one death attributable to prematurity. All other deaths were preventable, indicating that even lower mortality rates are feasible. Omphalocele was associated with a 23% incidence of premature birth but associated anomalies were present in 66% of the patients. Major cardiac (52%) and chromosomal defects (40%) predominated. In addition, 17% of omphalocele patients had either Cantrell's pentalogy or cloacal/bladder exstrophy. The mortality rate in omphalocele (34%) was nearly three times that of gastroschisis. Nine of ten patients who died from omphalocele died either from major cardiac or chromosomal disease. However, in patients without cardiac or chromosomal defects the survival rate was 94%.

Congenital anomalies are commonly associated with exomphalos minor

“…Traditional teaching attributes an increased incidence of anomalies of various organ systems with exomphalos major. The overall incidence of chromosomal anomalies, syndromes, and associated congenital malformations observed in this cohort is comparable to that reported in the literature (Table 2) [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]. However, with the current trend of improved survival, morbidity and mortality can be further minimized by determining specific anomalies to the size of the exomphalos and thereby establishing structured management strategies.…”

The Prognosis of Gastroschisis and Omphalocele

“…The mortality rate of omphalocele has been well known to be higher than that of gastroschisis [5,9,15,16]. Many studies demonstrated that this higher mortality was attributed to higher association of cardiac anomaly in omphalocele [17,18]. In our result, the mortality rate of omphalocele was lower than that of gastroschisis (15.0% vs. 23.3%), even though it was not significant.…”

Omphalocele and gastroschisis: An 18-year review study

“…1 However, it was not until recently that these two conditions were categorized as separate entities. In 1953, Moore and Stokes 2 defined the two separate conditions, and in 1963, Duhamel 3 emphasized their distinct pathogenesis and clinical presentations.…”