Gastroschisis: A Case Study

Gastroschisis is an abdominal defect caused by an infarction of the distal segment of the omphalomesenteric artery or umbilical vein. The bowel usually herniates through the site of the infarction later in the foetal life. Most of the neonates with this condition develop vascular impairment of the bowel leading to adhesions and then onto inflammation and thickening of the bowels resulting in poor prognosis and is a surgical emergency. Thus, our patient lost a large amount of fluids and heat when the bowels were exposed for too long and also developed sepsis (1).
Perioperative Assessment
In ideal settings the perioperative assessment for neonate initiates in the delivery room after the abnormality has been detected antenatal via ultrasonography. As soon as the baby is delivered early stabilization, intubation, oxygenation and ventilation is necessary. The bowels are usually covered with a sterile bag filled with normal saline and care is taken when handling the bowels to avoid trauma(1,2). Thus, this was not done for our patient since she had a village delivery and was brought late to the hospital. Her herniated bowels were not handled in a sterile manner and were exposed to heat and dirt. She was not able to be hydrated for 12 hours since cannulation was difficult at the Aid post and ended up being severely dehydrated and septic when she …show more content…
In a patient with an uncomplicated intraoperative course, there is a greater chance for making a primary closure. In contrast if the neonate is unstable-hypoxic, hypotensive and hernia is larger than 4cm, the surgical risk is greater and primary closure may not be possible (2,3). Thus, our patient was septic and severely dehydrated and was classified as ASA3. However, after fluid resuscitation, keeping the bowels covered and moist, maintaining the temperatures at normal and administering antibiotics; she became stable for

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