Faculty Collaboration Database

The significance of organ prolapse in gastroschisis. J Pediatr Surg 2017 Dec;52(12):1972-1976

Date

09/28/2017

Pubmed ID

28951014

DOI

10.1016/j.jpedsurg.2017.08.066

Scopus ID

2-s2.0-85029751025 (requires institutional sign-in at Scopus site)   10 Citations

Abstract

PURPOSE: The aim of this study was to evaluate the incidence and importance of organ prolapse (stomach, bladder, reproductive organs) in gastroschisis.

METHODS: This is a retrospective review of gastroschisis patients from 2000 to 2014 at a single tertiary institution. Statistical analysis was performed using a chi-square test, Student's t test, log-rank test, or Cox regression analysis models. All tests were conducted as two-tailed tests, and p-values <0.05 were considered statistically significant.

RESULTS: One hundred seventy-one gastroschisis patients were identified. Sixty-nine (40.6%) had at least one prolapsed organ besides bowel. The most commonly prolapsed organs were stomach (n=45, 26.3%), reproductive organs (n=34, 19.9%), and bladder (n=15, 8.8%). Patients with prolapsed organs were more likely to have simple gastroschisis with significant decreases in the rate of atresia and necrosis/perforation. They progressed to earlier enteral feeds, discontinuation of parenteral nutrition, and discharge. Likewise, these patients were less likely to have complications such as central line infections, sepsis, and short gut syndrome.

CONCLUSIONS: Gastroschisis is typically described as isolated bowel herniation, but a large portion have prolapse of other organs. Prolapsed organs are associated with simple gastroschisis, and improved outcomes most likely due to a larger fascial defect. This may be useful for prenatal and postnatal counseling of families.

TYPE OF STUDY: Case Control/Retrospective Comparative Study.

LEVEL OF EVIDENCE: Level III.

Author List

Koehler SM, Szabo A, Loichinger M, Peterson E, Christensen M, Wagner AJ

Authors

Erika Peterson MD Professor in the Obstetrics and Gynecology department at Medical College of Wisconsin
Aniko Szabo PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Enteral Nutrition
Female
Gastroschisis
Humans
Infant, Newborn
Male
Parenteral Nutrition, Total
Prolapse
Retrospective Studies
Stomach Diseases
Treatment Outcome
Urinary Bladder Diseases