臍帯基底部より腸管の脱出をみた新生児の1例 : 腹壁破裂の成因に関する文献的考察

概要

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A case of gastroschisis with special anatomical form, which is suggestive of its embryogenesis, is reported. Abdominal defect is not found and the evisceration of the intestine occurs at the base of the umbilical cord which has a normal appearance. Our case would not come under the classification of gastroschisis denned by Moore (1953), who presented the principal features of gastroschisis: normal umbilical cord insertion, defect being extraumbilical and no covering sac nor its remnants. Our case, however, can be considered gastroschisis according to the commonly accepted concept that gastroschisis is intrauterine rupture of the umbilical cord. But the definition by Moore is still referred to even now in order to differentiate gastroschisis from ruptured omphalocele. The existence of our case suggests that gastroschisis can be divided into following three types, according to the outside appearance at birth. 1) extraumbilical location of the defect adjacent to the umbilical cord 2) existence of the skin bridge between the abdominal defect and the umbilical cord 3) ruptured orifice in the normal umbilical cord without abdominal defect like our case Although the embryogenesis of gastroschisis is not clear, it seems that review concerning to the definition of gastroschisis should be required for the purpose of seeking after the truth.
日本小児外科学会の論文
1988-10-20