Gastroschisis

Gastroschisis

  • Cover exposed bowel with saline-soaked gauze.
  • Monitor CBC to check for infection (↑ WBC)
  • Keep baby warm
  • NPO, of course
  • NG to decompress stomach

Gastroschisis is a congenital abnormality where a defect in the abdominal wall allows the intestines to protrude through the opening.  The condition is typically diagnosed prenatally using ultrasound.  The priority interventions for this baby are: cover the bowel outside the body with a saline-soaked with sterile gauze and keep the baby warm.  Treatment: Firt, surgeons hang a “silo” of plastic material above the baby’s bed and attach it to the baby’s belly wall. The silo is a bag that protects the bowels.  then the bowel is reduced  and closure of abdominal defect occurs within 1 week.  Complications are bowel obstruction (abdominal distention, ↓ bowel sounds), infection (areas of ischemic bowel, fever, ↑ WBC), and short bowel syndrome if necrosis occur and some of the bowel needs to be removed. 

Let's do a case study

A newborn was brought to the neonatal intensive care unit (NICU) with a diagnosis of gastroschisis. The baby had been diagnosed with gastroschisis in utero.  The baby was born with his intestines and other abdominal organs protruding from a hole in the abdominal wall to the right of the umbilicus.

Gastroschisis

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