Gastroschisis and the Risk of Short Bowel Syndrome: Outcomes and Counselling

Abstract

Background: Gastroschisis can be associated with short bowel syndrome (SBS). We present 4 cases with significant bowel shortening with very different ante- and postnatal presentations. Cases: Three of the cases demonstrated ‘vanishing' gastroschisis with progressively worsening antenatal intra-abdominal bowel dilatation with no defect present at birth. The fourth case followed an uneventful course antenatally but developed SBS considered secondary to gastroschisis-related atresia and necrosis. All 4 cases were classified as having SBS and were enrolled within the paediatric Intestinal Rehabilitation Programme. This involves autologous gastrointestinal reconstruction following a period of bowel expansion with concomitant parenteral and enteral nutrition. Discussion: These cases demonstrate that the serious complication of significant bowel loss cannot always be anticipated. Early multidisciplinary discussion with the parents enables a shared understanding of potential outcomes. It can aid the recognition of ‘vanishing' gastroschisis enabling expedient investigations and early intervention, minimising morbidity and maximising bowel length.

Neurodevelopmental outcome of patients with congenital gastrointestinal malformations: a systematic review and meta-analysis

“…(3) early, long and/or repeated exposure to anaesthetics necessary for surgical correction(s) [16][17][18] ; (4) perioperative haemodynamics and respiratory functioning [19][20][21] ; (5) postoperative inflammatory challenges 22 23 ; and (6) poor nutritional status that can lead to an altered microbiome, influencing the developing brain through the gut-brain axis. [24][25][26][27] All these harmful challenges to the central nervous system may lead to neurodevelopmental impairment, which in turn may interfere with development in important domains of functioning, including academic achievement, behavioural functioning, and social and economic well-being. [28][29][30] The primary aim of the current systematic review is to quantitatively aggregate all available empirical evidence on the effects of having a congenital gastrointestinal malformation on neurodevelopment using…”

Feeding Intolerance and Poor Growth in Infants with Gastroschisis: Longitudinal Experience with Consecutive Patients over Thirteen Years

“…Studies of gastroschisis typically focus on the surgical approach to care and associated complications [5][6][7]. There is limited information available on optimizing enteral nutrition or maximizing postnatal growth in infants with gastroschisis [8][9][10].…”

Vanishing Gastroschisis with a Favorable Outcome after a 3-Year Follow-Up: A Case Report and Literature Review

“…Signs of closing gastroschisis in prenatal ultrasound should be carefully sought. Thereby, physicians can adapt prenatal counseling and prepare the parents for this complication and the need of multidisciplinary postnatal care [40].…”