Successful Treatment of Two Cases of Gastroschisis

概要

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Surgical management of gastroschisis associated with intestinal atresia is often difficult. We successfully treated two such gastroschisis cases, including one with an intestinal perforation. In both cases, primary repair of the intestinal atresia was not possible because of intestinal edema. The first case had jejunal atresia. We performed a staged repair of the abdominal wall using a silo and decompressed the gastrointestinal tract via a nasogastric tube. The second case had colonic atresia and the caecum was perforated. We constructed a silo pouch and inserted a drainage tube into the intestine through the perforation site. In the first case, the silo was progressively tightened and the intestine was repositioned into the abdominal cavity in six days, and a delayed anastomosis was safely performed at nine days of age. In the second case, we performed an abdominal wall closure and stoma construction five days after birth. Stoma closure was performed at 70 days of age. In both cases, the postoperative course was uneventful. Intestinal atresia in gastroschisis cases can be safely managed with a delayed repair. In these cases, a nasogastric tube was adequate for decompression; and tube drainage via the perforation site may be recommended in those with intestinal perforation.
2007-08-01