Abdomen / Pelvis for Tuesday, April 8th, 2025
Contributed by
Cincinnati Children's Hospital
Sara M. O'Hara, MD.
History
Newborn infant, no prenatal imaging.
Images (Click any image to enlarge)
Question
What is the diagnosis?
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Correct answer
Gastroschisis
Discussion
This is gastroschisis, a congenital abdominal wall defect adjacent to the umbilicus, with no sac or covering of the herniated bowel. Most cases are simple, but 10-20% have associated bowel atresia(s), bowel ischemia/necrosis, or perforation. Primary repair may be possible if small length of bowel is extra-abdominal. Most cases require an abdominal silo to temporarily confine and protect the bowel until gravity helps the loops reduce into the abdominal cavity. Long term issues with bowel motility and/or short gut can complicate recovery.
Differential diagnosis
Malrotation/volvulus occurs intra-abdominally when there is abnormal or insufficient fixation of the mesenteric root. Omphalocele is a covered herniation of abdominal contents with the umbilicus extending from the hernia sac. Cloaca exstrophy is abnormal herniation of the urinary bladder but typically without herniation of bowel.
Additional images
References
- https://my.statdx.com/document/gastroschisis/82b0e01e-6484-47a5-986b-cedbf6949af8?term=Gastroschisis&searchType=documents&category=All&documentTypeFilters=all