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May 1971

Surgical Treatment of Gastroschisis: Description of a Modification of the Staged Treatment for Large Defects

Author Affiliations

From the Department of Surgery, Kauikeolani Children's Hospital and University of Hawaii School of Medicine, Honolulu.

Arch Surg. 1971;102(5):524-529. doi:10.1001/archsurg.1971.01350050090026

In three cases of gastroschisis the first patient was treated by immediate skin coverage and fascial repair 20 months later; the second was treated by segmental intestinal resection, but the infant died after 3½ weeks following another exploration for obstruction; and the last patient was treated by temporary enclosure of the intestines with a silicone and polyester sack. Attention is called to the importance of pulling the rectus edges together by lateral plication of the sack after the intestines have been squeezed into the abdomen. Defects over 4 cm cannot be closed with safety unless the sack is gradually plicated. Supportive measure to conserve heat and ventilatory reserve are urged.