Abdominal wall defects – gastroschisis, omphalocele

Czech version

Authors: E. Orlová ¹; M. Brejchová ²; B. Kučerová ³
Authors‘ workplace: Novorozenecké oddělení s JIRP, FN Motol, Praha ¹; Gynekologicko-porodnická klinika 2. LF UK a FN Motol, Praha ²; Klinika dětské chirurgie 2. LF UK a FN Motol, Praha ³
Published in: Čes-slov Neonat 2024; 30 (1): 19-24.
Category: Reviews

Overview

Abdominal wall defects are some of the most common congenital anomalies met in the pediatric population. These defects include two separate pathologies: gastroschisis and omphalocele, which have divergent pathophysiologic origins, clinical manifestations, and management strategies. Both are usually diagnosed prenatally using fetal ultrasonography, and affected patients should be treated at centers with access to high-risk obstetric, neonatology and pediatric surgery services. Delivery outside a perinatal center is a significant predictor of complications for infants born with gastroschisis. Choosing the most suitable surgical technique, with detailed postoperative monitoring of the patient, is particularly important due to the risk of possible abdominal compartment syndrome. Overall, the long-term outcome and survival for these patients is good and the results of patients in Czech Republic are comparable to most developed countries in the world. In this review, we discuss the distinguishing features, current management strategies, and outcomes of patients with these defects.

Keywords:

gastroschisis – omphalocele – intra-abdominal pressure – abdominal compartment syndrome

Sources

Bauman B, Stephens D, Gershone H, et al. Management of giant omphaloceles: A systematic review of methods of staged surgical vs. nonoperative delayed closure. J Pediatr Surg 2016; 51(10): 1725–1730. Dostupné z: doi: 10.1016/j.jpedsurg.2016.07.006.
Carpenter JL, Wiebe TL, Cass DL, Olutoye OO, Lee TC. Assessing quality of life in pediatric gastroschisis patients using the pediatric quality of life inventory survey: An institutional study. J Pediatr Surg 2016; 51(5): 726–729.
Cohen-Overbeek TE, Hatzmann TR, Steegers EA, et al. The outcome of gastroschisis after a prenatal diagnosis or a diagnosis only at birth. Recommendations for prenatal surveillance. Eur J Obstet Gynecol Reprod Biol 2008; 139: 21−27.
Stallings EB, Isenburg JL, Rutkowski RE, Kirby RS, Nembhard WN, Sandidge T, Villavicencio S, Nguyen HH, McMahon DM, Nestoridi E, Pabst LJ; National Birth Defects Prevention Network. National population-based estimates for major birth defects, 2016–2020. Birth Defects Res 2024; 116(1): e2301. Dostupné z: doi: 10.1002/bdr2.2301.
Frýbová B, Kokešová A, Vlk R, Rygl M. Predikce poškození střeva u pacientů s gastroschízou. Rozhledy v chirurgii 2018; 97(3): 105–108.
Frýbová B, Kokešová A, Zemková D, Mixa V, Vlk R, Rygl M. Quality of life in patients with gastroschisis is comparable with the general population: A questionnaire survey. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2017; 161(1): 75–79. Dostupné z: doi: 10.5507/bp.2016.059.
Frýbová B, Vlk R, Kokešová A, Rygl M. Isolated prenatal ultrasound findings predict the postnatal course in gastroschisis. Pediatr Surg Int 2015; 31(4): 381–387. Dostupné z: doi: 10.1007/ s00383-015-3675-2.
Holcomb GW, Murphy JD, Ostlie DJ. Ashcraft’s Pediatric Surgery. 6th ed. Philadelphia: Elsevier 2014: 660−672.
Huh NG, Hirose S, Goldstein RB. Prenatal intra-abdominal bowel dilation is associated with postnatal gastrointestinal complications in fetuses with gastroschisis. Am J Obstet Gynecol 2010; 202: 391−396. Dostupné z: doi: 10.1016/j.ajog.2009.10.888.
Kokešová A, Coufal S, Frýbová B, Kverka M, Rygl M, Martin Camilla R. The intestinal fatty acid-binding protein as a marker for intestinal damage in gastroschisis. PLOS ONE 2019;14(1). Dostupné z: https://dx.plos.org/10.1371/journal.pone. 0210797.
Lap CC, Brizot ML, Pistorius LR, et al. Outcome of isolated gastroschisis: An international study, systematic review and meta-analysis. Early Hum Dev 2016; 103: 209−218. Dostupné z: doi: 10.1016/j.earlhumdev.2016.10.002.
Ross AR, Eaton S, Zani A, et al. The role of preformed silos in the management of infants with gastroschisis: A systematic review and meta-analysis. Pediatr Surg Int 2015; 31: 473−483. Dostupné z: doi: 10.1007/s00383-015-3691-2.
Slater BJ, Pimpalwar A. Abdominal wall defects. Neoreviews 2020; 21(6): e383−e391. Dostupné z: doi: 10.1542/neo.21-6e383.
Suominen PK, Pakarinen MP, Rautiainen P, et al. Comparison of direct and intravesical measurement of intraabdominal pressure in children. J Pediatr Surg 2006; 41: 1381–1385. Dostupné z: doi: 10.1016/j.jpedsurg.2006.04.030.
Marshall J, Salemi JL, Tanner JP, et al; National Birth Defects Prevention Network. Prevalence, correlates, and outcomes of omphalocele in the United States in 1995–2005. Obstet Gynecol 2015; 126(2): 284–293.
Nasr A, Langer JC; Canadian Paediatric Surgery Network. Influence of location of delivery on outcome in neonates with gastroschisis. J Pediatr Surg 2012; 47(11): 2022–2025. Dostupné z: doi: 10.1016/j.jpedsurg.2012.07.037.

Konflikt zájmu: žádný. Došlo do redakce: 5. 3. 2024

Adresa pro korespondenci:
MUDr. Ekaterina Orlová
Novorozenecké oddělení s JIRP
Gynekologicko-porodnická klinika 2. LF UK a FN Motol
V Úvalu 84
150 06 Praha 5
e-mail: ekaterina.orlova@fnmotol.cz