Congenital defect with opening in abdominal wall through which organs may protrude.Encyclopedia Entry for Gastroschisis :Gastroschisis repair. The goal of the procedure is to place the organs back into the baby's belly and fix the defect. Repair may be done right after the baby is born. This is called primary repair. Or, the repair is done in stages. This is called staged repair. Surgery for primary repair is done in the following way: If possible, the surgery is performed the day your baby is born. This surgery is done when there is only a small amount of intestine outside the belly and the intestine isn't very swollen. Right after birth, the intestine that is outside the belly is placed in a special bag or is covered with a plastic wrap to protect it. Your baby is then prepared for surgery. Your baby receives general anesthesia. This is medicine that allows your baby to sleep and be pain-free during the operatio The surgeon examines your baby's intestine (bowel) closely for signs of damage or other birth defects. Unhealthy parts are removed. The healthy edges are stitched together. The intestine is placed back into the belly. The opening in the wall of the belly is repaired. Staged repair is done when your baby isn't stable enough for primary repair. It may also be done if the baby's intestine is very swollen or there is a large amount of intestine outside the body. Or, it is done when the baby's belly isn't large enough to contain all of the intestine. The repair is performed the following way: Right after birth, the baby's intestine and any other organs that are outside the belly are placed in a long plastic pouch. This pouch is called a silo. The silo is then attached to the baby's belly. The other end of the silo is hung above the baby. This allows gravity to help the intestine to slip into the belly. Each day, the health care provider also gently tightens the silo to push the intestine into the belly. It may take up to 2 weeks for all of the intestine and any other organs to be back inside the belly. The silo is then removed. The opening in the belly is repaired. More surgery may be needed at a later time to repair the muscles in your baby's belly.Gastroschisis is a life-threatening condition. It needs to be treated soon after birth so that the baby's organs can develop and be protected in the belly.Risks for anesthesia and surgery in general are: Allergic reactions to medicines Breathing problems Bleeding Infection Risks for gastroschisis repair are: Breathing problems if the baby's belly area (abdominal space) is smaller than normal. The baby may need a breathing tube and breathing machine for a few days or weeks after surgery. Inflammation of tissues that line the wall of the abdomen and cover the abdominal organs. Organ injury. Problems with digestion and absorbing nutrients from food, if a baby has a lot of damage to the small bowel. Temporary paralysis (muscles stop moving) of the small bowel. Abdominal wall hernia.Gastroschisis is usually seen on ultrasound before the baby is born. The ultrasound may show loops of bowel freely floating outside the baby's belly. After gastroschisis is found, your baby will be followed very closely to make sure he or she is growing. Your baby should be delivered at a hospital that has a neonatal intensive care unit (NICU) and a pediatric surgeon. A NICU is set up to handle emergencies that occur at birth. A pediatric surgeon has special training in surgery for babies and children. Most babies who have gastroschisis are delivered by cesarean section.After surgery, your baby will receive care in the NICU. The baby will be placed in a special to keep your baby warm. Your baby may need to be on a breathing machine until organ swelling has decreased and the size of the belly area has increased. Other treatments your baby will probably need after surgery are: A nasogastric (NG) tube placed through the nose to drain the stomach and keep it empty. Antibiotics. Fluids and nutrients given through a vein. Oxygen. Pain medicines. Feedings are started through the NG tube as soon as your baby's bowel starts functioning after surgery. Feedings by mouth will start very slowly. Your baby may eat slowly and may need feeding therapy, lots of encouragement, and time to recover after a feeding. The average stay in the hospital is a few weeks up to a few months. You may be able to take your baby home once he or she is taking all foods by mouth and gaining weight.After you go home, your child may develop a blockage in the intestines ( bowel obstruction ) due to a kink or scar in the intestines. The doctor can tell you how this will be treated. Most of the time, gastroschisis can be corrected with one or two surgeries. How well your baby does will depend on how much damage there was to the intestine. After recovering from surgery, most children with gastroschisis do very well and live normal lives. Most babies who are born with gastroschisis do not have any other birth defects.Abdominal wall defect repair - gastroschisis.Gastroschisis repair - series Gastroschisis repair - series.Chung DH. Pediatric surgery.Encyclopedia Entry for Gastroschisis :Gastroschisis. Babies with gastroschisis are born with a hole in the abdominal wall. The child's intestines often stick out (protrude) through the hole. The condition looks similar to an omphalocele. An omphalocele, however, is a birth defect in which the infant's intestine or other abdominal organs protrude through a hole in the belly button area and are covered with a membrane. With gastroschisis, there is no covering membrane. Abdominal wall defects develop as a baby grows inside the mother's womb. During development, the intestine and other organs (liver, bladder, stomach, and ovaries, or testes) develop outside the body at first and then usually return inside. In babies with gastroschisis, the intestines (and sometimes the stomach) remain outside the abdominal wall, without a membrane covering them. The exact cause of abdominal wall defects is not known. Mothers with the following may be at higher risk of having babies with gastrochisis: Younger age Fewer resources Poor nutrition during pregnancy Use illegal substances Babies with gastroschisis usually do not have other related birth defects.A gastroschisis can be seen when the baby is born. There is a hole in the abdominal wall. The small intestine is often outside the abdomen near the umbilical cord. Other organs that may also be seen are the large intestine, stomach, or gallbladder. If the intestine is damaged, the baby will have problems absorbing food.Prenatal ultrasounds often identify infants with gastroschisis before birth. While pregnant, the mother may have shown signs of too much amniotic fluid ( polyhydramnios ). A prenatal ultrasound often identifies the gastroschisis.If gastroschisis is found before birth, the mother will need special monitoring to make sure her unborn baby remains healthy. Treatment for gastroschisis is surgery to repair the defect. The surgeon will put the bowel back into the abdomen and close the defect, if possible. If the abdominal cavity is too small, a mesh sack is stitched around the borders of the defect and the edges of the defect are pulled up. The sack is called a silo. Over 5 to 7 days, the intestine returns into the abdominal cavity and the defect can be closed. Other treatments for the baby include nutrients by IV and antibiotics to prevent infection. The baby's temperature must be carefully controlled, because the exposed intestine allows a lot of body heat to escape.The baby has a good chance of recovering if there are no other problems and if the abdominal cavity is large enough. A very small abdominal cavity may result in complications that require more surgeries. Plans should be made for careful delivery and immediate management of the problem after birth. The baby should be delivered in a medical center that is skilled at repairing abdominal wall defects. Babies are likely to do better if they do not need to be taken to another center for further treatment.A small number of babies with gastroschisis (about 10%) may have parts of the intestines that did not develop normally in the womb. With these babies, their intestines may not work normally even after the organs are put back inside the abdominal cavity. The increased pressure from the misplaced abdominal contents can decrease blood flow to the intestines and kidneys. It can also make it difficult for the baby to expand the lungs, leading to breathing problems. Another complication is bowel death necrosis. This occurs when intestinal tissue dies due to low blood flow or infection. This condition is apparent at birth and will be detected in the hospital at delivery if it has not already been seen on routine fetal ultrasound exams during pregnancy. If you have given birth at home and your baby appears to have this defect, call the local emergency number (such as 911) right away.This problem is diagnosed and repaired in the hospital at birth. After returning home, call your health care provider if your baby develops any of these symptoms: Decreased bowel movements Feeding problems Fever Green or yellowish green vomit Swollen belly area Vomiting (different than normal baby spit-up) Worrisome behavioral changes.Birth defect - gastroschisis; Abdominal wall defect - infant; Abdominal wall defect - neonate; Abdominal wall defect - newborn.Infant abdominal hernia (gastroschisis) Infant abdominal hernia (gastroschisis) Gastroschisis repair - series Gastroschisis repair - series.Gottlieb LJ, Reid RR, Slidell MB. Pediatric chest and trunk defects.