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Gastroschisis and the risk of short bowel syndrome: outcomes and counselling. | LitMetric

AI Article Synopsis

  • Three cases of gastroschisis showed 'vanishing' symptoms with no detectable defect at birth, while a fourth developed short bowel syndrome (SBS) due to complications related to gastroschisis.
  • All four patients were classified with SBS and participated in a pediatric program focusing on intestinal rehabilitation through bowel expansion and nutrition support.
  • The study highlights the importance of early discussions with parents about the potential for significant bowel loss, which can aid in identifying cases of 'vanishing' gastroschisis and encourage timely interventions to improve outcomes.

Article Abstract

Background: Gastroschisis can be associated with short bowel syndrome (SBS). We present 4 cases with significant bowel shortening with very different ante- and postnatal presentations.

Cases: Three of the cases demonstrated 'vanishing' gastroschisis with progressively worsening antenatal intra-abdominal bowel dilatation with no defect present at birth. The fourth case followed an uneventful course antenatally but developed SBS considered secondary to gastroschisis-related atresia and necrosis. All 4 cases were classified as having SBS and were enrolled within the paediatric Intestinal Rehabilitation Programme. This involves autologous gastrointestinal reconstruction following a period of bowel expansion with concomitant parenteral and enteral nutrition.

Discussion: These cases demonstrate that the serious complication of significant bowel loss cannot always be anticipated. Early multidisciplinary discussion with the parents enables a shared understanding of potential outcomes. It can aid the recognition of 'vanishing' gastroschisis enabling expedient investigations and early intervention, minimising morbidity and maximising bowel length.

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Source
http://dx.doi.org/10.1159/000351038DOI Listing

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