Gastroschisis with gastric perforation and jejunal stenosis A rare association of anomalies

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COD: 12_263-267 Categorie: ,

Vesna Milojkovic Marinovic, Marija Lukac Lukac, Zˇeljko Mikovic, Blagoje Grujic, Aleksandra Stojanovic, Dalibor Sabbagh, Gordana Samardžija

Ann. Ital. Chir., 2016 87: 263-267

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AIM: Gastroschisis with prenatal gastric perforation and intestinal stenosis is a rare and serious anomaly. although there
are several case reports, no case series exists to suggest the prognosis for these infants.
MATERIAL AND METHODS: In this report a case of gastroschisis with gastric perforation and jejunal stenosis in male newborn
is presented with literature review. The stomach, small bowel and the part of the colon were herniated through
the abdominal wall defect. A large perforation site at the anterior wall of fundus and a thin fibrous strip that causing
stenosis of jejunum was found.
RESULTS: Gastrorraphy was performed. Stenosis of jejunum was resected and t-t anastomosis was performed, followed by
primary fascial closure.
DISCUSSION: The prenatal sonographic finding of bowel or gastric perforation are variable. Antenatal bowel dilatation
and in particular intraabdominal bowel dilatation is prognostically useful for detection of patients with worse outcome.
The absence of bowel dilatation cannot fully exclude complex patients. Early restoration of bowel continuity using primary
anastomosis and primary abdominal wall closure are not associated with prolonged time for full enteral feeding
and length of hospital stay.
CONCLUSIONS: We have presented the first detailed report of surgical intervention and outcomes in case of gastroschisis
with prenatal gastric perforation and congenital jejunal stenosis. Early restoration of bowel continuity using primary anastomosis
and primary abdominal wall closure is recommended here. More research should be focused to predict complex
gastroschisis and to improve prenatal diagnosis and postnatal management, without a significant increase in morbidity
and mortality.

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