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Abstract
Gastroschisis complicated by intestinal atresia is a complex problem. Six cases are
presented. A review of the literature and of our own cases shows a high mortality
rate. Success or failure is related more to the pathology present than to any specific
method of operative management. Resection and primary anastomosis is the favored method
of treatment, as the intestine heals well in spite of its appearance. Primary closure
of the abdominal wall musculature and skin is done whenever possible. A gastrostomy
is used uniformly. Intravenous hyperalimentation is critical to survival of these
babies and should be used early. The use of this therapeutic modality allows for the
onset of gastrointestinal function spontaneously (often over prolonged periods of
time) without nutritional deprivation. Intestinal atresias almost always are easy
to identify in babies with gastroschisis. Extensive dissection and mobilization of
this friable intestine is contraindicated in those babies in whom an atresia is not
obvious but only suspected. In such cases the gastroschisis defect should be managed
by whatever method is deemed appropriate and the baby observed while receiving intravenous
nutritional support. If an atresia is present, it can be managed later in the baby's
course by resection and primary anastomosis.
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Article info
Footnotes
☆Presented at the Thirty-fourth Annual Meeting of the Central Surgical Association, Buffalo N.Y., March 3–5 1977.
Identification
Copyright
© 1977 Published by Elsevier Inc.
