Left-Sided Gastroschisis

Abstract

Gastroschisis is a periumbilical, abdominal wall defect arising to the right of the umbilicus. We describe the clinical course of a left-sided gastroschisis in a term female born at 39 weeks’ gestation. To our knowledge, there have been only 14 left-sided abdominal wall defects reported in the literature. We discuss our case and review the literature to try to determine if there is any clinic difference between right- versus left-sided lesions to make recommendations as to management.

A case report of an infant with both left-sided gastroschisis and septo-optic dysplasia and literature review: possible shared etiology?

“…The classic description is of a smooth edged defect typically smaller than 4 cm and almost always to the right of the umbilicus. 8,9 It has an estimated incidence of 2-5/10,000 births and appears to be increasing over the past 20 years. 8,10 A recent CDC report from 14 states showed an increased prevalence of 30% between 1996-2005 (3.6/10,000) compared to 2006-2012 (4.9/10,000).…”

“…16 Several of these theories implicate events occurring at a similar time in fetal life -between the 4-8th week of gestation. Left-sided gastroschisis is quite rare, 9,14,[17][18][19][20] but differs from the more common right-sided lesion in several ways. First, although the incidence of right-sided gastroschisis is similar between male and female infants, left-sided gastroschisis occurs more often in girls.…”

Left-sided Gastroschisis: Is it the Same Pathology as on the Right-Side?

“…He suggests that left-sided gastroschisis is a distinct phenomenon from the right-sided form. In 10 of the 13 reported cases with typical periumbilical defects [4,5,10,11,16,20,21] , the mesenteric disposition and the prenatal age at diagnosis were not mentioned, so that the moment when the malformation appeared cannot be inferred. In our two cases, only a late rupture at the junction of the cord and the body wall can explain the anatomical observations.…”

Management of Gastroschisis

“…Gastroschisis (GS) or more aptly "laparoschisis" is a congenital abdominal wall defect (AWD) leading to herniation of the gut more commonly to the right of the umbilical cord (Figure 1). It differs from other AWDs in causality, risk factors, and associated anomalies [1][2][3].…”