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April 1974


Author Affiliations

St. Louis
From the departments of surgery (Drs. Binnington and Ternberg) and pediatrics (Dr. Keating), Washington University School of Medicine, St. Louis.

Arch Surg. 1974;108(4):455-459. doi:10.1001/archsurg.1974.01350280061011

The care of seven consecutive infants born with gastroschisis and successfully treated by primary closure is reviewed to determine factors leading to their survival. The use of intravenous alimentation has prevented malnutrition from the prolonged bowel dysfunction present in most children born with gastroschisis. Reoperation for presumed small intestinal obstruction has decreased with the recognition that prolonged ileus is to be expected and that radiologic studies cannot distinguish between mechanical and functional problems. Neonates have arrived in better condition than in the past due to initiation of therapy before and during transfer. Broad-spectrum antibiotic coverage helps prevent septic complications. Finally, we believe that lactose and other digestive enzyme deficiencies are present in these babies so that a nonlactose-based, predigested formula should be fed once gastrointestinal tract function is present.