DIAGNOSTIC CRITERIA FOR VISCEROABDOMINAL DISPROPORTION SYNDROME IN GASTROSCHISIS

2021 ◽  
Vol 100 (6) ◽  
pp. 53-59
Author(s):  
D.A. Plokhikh ◽  
◽  
D.E. Beglov ◽  
K.A. Kovalkov ◽  
◽  
...  

The objectives of this study were to determine the frequency and search for additional criteria for the diagnosis of visceroabdominal disproportion syndrome (VADS) in newborns with gastroschisis. Materials and methods of research: prospective controlled observational cross-sectional analytical study was carried out in 61 newborns with gastroschisis, admitted from June 2009 to July 2021. To search for the most significant factors indicating the presence of VADS, the following parameters were recorded in the studied patients: the size of the defect in the anterior abdominal wall, the composition of eventrated organs, the presence of a conglomerate of intestinal loops, the diameter of the intestinal tube, the thickness of the intestinal wall, the degree of visceroabdominal disproportion (VAD). Results: VAD was detected in 50 (82%) newborns with gastroschisis. In 10 (17%) cases, VAD was mild, in 27 (44%) – moderate, and in 13 (21%) patients – severe. A moderate direct relationship was found between the size of the anterior abdominal wall defect (r=0.29, p=0.022), intestinal tube diameter (r=0.56; p=0.001) and the severity of VAD. There was a strong direct correlation between the thickness of the intestinal wall, and the frequency and severity of VAD (r=0.93, p=0.001). A direct association was found between the presence of a conglomerate of intestinal loops in the eventrated organs and the frequency of VAD (p=0.002). There was no statistically significant relationship between the number of eventrated anatomical structures with the frequency and degree of VAD (p=0.36). Conclusion: to determine VADS, it is advisable to diagnose the following pathological conditions in patients with gastroschisis: thickening of the intestinal wall, dilatation of the intestinal tube, the presence of a conglomerate of tightly welded eventrated organs, the severity of which is directly proportional to the degree of disproportion.

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
K. D. Ojuka ◽  
F. Nangole ◽  
M. Ngugi

Degloving injuries to anterior abdominal wall are rare due to the mechanism of injury. Pedicled tensor fascia lata is known to be a versatile flap with ability to reach the lower anterior abdomen. A 34-year-old man who was involved in a road traffic accident presented with degloving injury and defect at the left inguinal region, sigmoid colon injury, and scrotal bruises. At investigation, he was found to have pelvic fracture. The management consisted of colostomy and tensor fascia lata to cover the defect at reversal. Though he developed burst abdomen on fifth postoperative day, the flap healed with no complications.


2019 ◽  
Vol 6 (38) ◽  
pp. 2603-2605
Author(s):  
Ritu Saloi ◽  
Roonmoni Deka ◽  
Santanu Kumar Sarma

2021 ◽  
pp. 15-19
Author(s):  
O.K. Sliepov ◽  
N.Y. Zhylka ◽  
V.L. Veselskyi ◽  
N.Y. Skrypchenko ◽  
T.V. Avramenko ◽  
...  

Background. Despite the existence of numerous studies on the optimal delivery mode in gastroschisis (GS), their results remain controversial. Therefore, the presented study is focused on establishing the delivery mode impact on GS anatomy in newborns.Research objective. The study was conducted to determine the impact of the delivery mode on the features of GS anatomy in newborns.Materials and methods. A retrospective analysis of medical records of 135 pregnant women and 135 their newborns with GS born between 1987 and 2020 was conducted. All newborns are divided into 3 groups. Newborns delivered by caesarean section are included in group I (n = 80); children born exclusively naturally are included in groups II (n = 25) and III (n = 30). The following anatomical features of GS in newborns were studied: localization and size of the anterior abdominal wall defect, confluence with the abdominal cavity, the nature and frequency of the eventrated organs.Results. The size of the anterior abdominal wall defect was significantly smaller in children with GS delivered by caesarean section (3.02 ± 0.58 cm; p < 0.01) than in children born naturally (4.17 ± 0.3 cm in group II, 4.7 ± 0.29 cm in group III). The frequency of retroperitoneal organs eventration was significantly less (20.0%; p < 0.01) in caesarean delivery grope than in II and III groups (52% and 63.3%, respectively). There was no significant difference in frequency of other abdominal organs eventration, localization of the anterior abdominal wall defect and confluence with the abdominal cavity. Level of evidence – III. Conclusions. The mode of delivery affects the size of abdominal wall defect and frequency of the abdominal organs eventration in newborns with GS.


Author(s):  
Mahesweta Guru ◽  
Shefali Patil

Gastroschisis is a congenital anterior abdominal wall defect, adjacent and usually to the right of the umbilical cord insertion. Gastroschisis has no covering sac and no associated syndromes. This differentiates it from an omphalocele, which usually is covered by a membranous sac. G4P3L1D2 by date 37 weeks by scan 37 weeks (17.2) Ultrasonography S/O Gastrochisis delivered a male baby of 2.4kg and was shifted to the NICU. The exposed contents were given cellulose dressing. On post-natal day 2 baby was taken for abdominal wall repair. Baby was started on Ryle’s tube feeding and was further managed by the neonatologist. 


2018 ◽  
pp. 220-225
Author(s):  
M. I. Pykov ◽  
Е. A. Filippova ◽  
O. V. Teplyakova ◽  
Е. I. Dorofeeva ◽  
N. N. Dzhandzhgava

Gastroschisis is a complex anterior abdominal wall defect requiring urgent surgical repair. Oneor two-stage surgery to return the intestines to the abdominal cavity may result in developing acute renal failure. Preservation of the Arantsiev duct lumen provokes serious changes in the portal vein system. The state of the microcirculatory bloodstream in the intestinal wall clearly correlates with the clinical data indicating the restoration of the passage through the gastrointestinal tract.


2018 ◽  
Vol 5 (3) ◽  
pp. 1142
Author(s):  
Rajkumar M. Meshram ◽  
Amruta Phatak ◽  
Arvind Bhurke ◽  
Chetan Chaudhari

Omphalocele is an anterior abdominal wall defect at the base of the umbilical cord, with herniation of the abdominal contents which are covered by a membrane and associated with a very high incidence of structural and chromosomal anomalies including heart defect, vesical, genital or diaphragmatic malformations. A 1000 gm preterm neonate was born vaginally, to a non-consanguineously married primi mother with uneventful pregnancy. On examination baby had a large anterior abdominal wall defect covered by a thin membrane with widely open and bulging anterior fontanellae. Eyes, ears and lips were well developed but eyelids were fused. Liver, spleen and intestine were visible under a thin transparent membrane. Rib cage was formed, and ribs were palpable but lower limbs were directed posteriorly and genitalia was ambiguous. Baby was in gasping condition and died within 30 minutes after birth. Prenatal accurate diagnosis by providing adequate antenatal care and ultrasonogram would permit an opportunity to counsel the family and to prepare for optimal postnatal care.


Author(s):  
Rajesh Tile ◽  
Supriya Jamkhandi

Pentology of Cantrell a rare congenital disorder of unknown etiology consists of pentad of: defect in the diaphragm, abdominal wall defect, deficiency of the pericardium and intracardiac defects. The hallmark diagnostic findings being ectopia cordis and omphalocoele. The exact pathogenesis is not clear, and the prognosis of this lethal condition depends on the severity of anterior abdominal wall defect and associated cardiac anamoly. Antenatal ultrasonography is a reliable tool of diagnosis and allow for termination of pregnancy if done before 20weeks of pregnancy. First described by Cantrell in 1958, very few cases have been reported till now in the literature. Authors describe here a case of a neonate delivered at 32weeks of gestation weighing 2.3kg at their hospital with typical features of Cantrells’ Pentology associated with a rare interesting finding of absent external genitalia and presence of lumbar meningocoele.


2017 ◽  
Vol 23 (2) ◽  
pp. 83-93
Author(s):  
Eva Gudemac ◽  
S. Babuci ◽  
C. Tica ◽  
V. Petrovici ◽  
V. Nacu ◽  
...  

AbstractIn the present paper, we refer to a method of primary closure of congenital defects of the anterior abdominal wall with tensionless viscero-abdominal disproportion. The study group included 10 animals subjected to surgery of the abdominal wall defect closure with bovine pericardium graft preserved in 0.5% formaldehyde, and 5 rabbits of the same breed and weight, in which bovine fascia graft was used as implant, being preserved in 0.5% formaldehyde. The abdominal anterior wall defect was made surgically by excision of the musculo-fascial structures and peritoneum. Bovine pericardium graft and bovine fascia graft were placed and fixed posteriorly to rectus abdominals muscles, having direct contact with the intra-abdominal contents and protected by suturing skin and subcutaneous layer.The purpose of the study was to perform a comparative postoperative evaluation of local macroscopic and microscopic changes that develop after reconstruction of the major abdominal wall defects experimentally induced in rabbits, using bovine pericardium and bovine fascia grafts preserved in 0.5% formaldehyde.In cases of major fascial defects of the anterior abdominal wall, bovine pericardium graft has acceptable strength and biocompatibility, having stabilizing properties of the abdominal wall due to the development of the connective tissue layer located between the implant and the subcutaneous layer. Bovine fascia grafts preserved in formaldehyde have an insignificant irritating and inflammatory action on the intestinal loops compared with bovine pericardium, and do not induce the development of a significant abdominal adhesion process, this allowing their use in the abdominal fascial defects closure with placement in direct contact with the abdominal contents.


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