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August 1973

GastroschisisTen-Year Review

Author Affiliations

St. Louis
From the departments of surgery, Saint Louis University School of Medicine and Cardinal Glennon Memorial Hospital for Children, St. Louis.

Arch Surg. 1973;107(2):218-222. doi:10.1001/archsurg.1973.01350200086020

Thirty-one infants with gastroschisis have been treated during the past ten years with a mortality of 32%. Improvement in management has resulted in only five deaths in the last 20 cases. The decrease in mortality seems directly related to prompt efficient preoperative treatment emphasizing preservation of body heat, decompression of the stomach with a nasogastric tube and evacuation of meconium with rectal irrigation. Stretching of the abdominal wall, gastrostomy, and primary closure is the treatment of choice in the perinatal group. In the antenatal group, coverage of the viscera with a polyester-reinforced silicone elastomer sheeting seems very effective in providing adequate coverage. The use of gas analyses, respiratory assistance, and parenteral alimentation allows support of the infant until the abdominal wall can be closed and orally administered nourishment established.