| Closed gastroschisis: total parenteral nutrition-free survival with aggressive attempts at bowel preservation and intestinal adaptation. | |
| | |
MedLine Citation:
|
PMID: 18558174 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: In infants with gastroschisis antenatal closure of the umbilical defect results in a proximal atresia with ischemia and/or volvulus of the extracorporeal midgut. It has been described as "closed gastroschisis" or "vanishing midgut." METHODS: A 10-year review of 219 gastroschisis patients identified 10 infants with this rare complication. RESULTS: In these 10 infants, the extracorporeal midgut was invariably matted and fibrosed. In 3 cases, the midgut had completely "vanished." In the remaining 7 cases, the remnant midgut was surgically reduced into the abdominal cavity with care not to compromise the diminutive vascular pedicle. Abdominal exploration was performed several weeks later to reestablish bowel continuity; 4 required an ostomy and 2 underwent a serial transverse enteroplasty. Mean residual length of salvaged small bowel was 79 cm with retention of the distal half of the colon. Eight infants survived the initial hospitalization, with a mean length of stay of 121 days and mean hospital charge of $287,094. Six of the 7 long-term survivors have been completely weaned off total parenteral nutrition. CONCLUSION: A nihilistic attitude toward infants with closed gastroschisis may not be uniformly supported because in the majority of these infants' long-term independence from total parenteral nutrition was achieved. |
| | |
Authors:
|
Sarah A Vogler; Stephen J Fenton; Eric R Scaife; Linda S Book; Daniel Jackson; Peter F Nichol; Rebecka L Meyers |
Related Documents
:
|
6612254 - Myocardial protection in infant open heart surgery. 2748234 - A new type of lethal short-limbed dwarfism. 1957264 - Patterns and trends of multiple congenital anomalies in birth defects surveillance syst... 3883714 - Clinical course of fetal hydrocephalus: 40 cases. 4037774 - Pharmacokinetic evaluation of cefoperazone in infants. 10472064 - Shoulder dystocia: an obstetric emergency. |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Journal of pediatric surgery Volume: 43 ISSN: 1531-5037 ISO Abbreviation: J. Pediatr. Surg. Publication Date: 2008 Jun |
Date Detail:
|
Created Date: 2008-06-18 Completed Date: 2008-08-28 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0052631 Medline TA: J Pediatr Surg Country: United States |
Other Details:
|
Languages: eng Pagination: 1006-10 Citation Subset: IM |
Affiliation:
|
Department of Surgery, University of Utah, Salt Lake City, UT 84132, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adaptation, Physiological Cause of Death* Cohort Studies Female Fetal Diseases / surgery*, ultrasonography Follow-Up Studies Gastroschisis / diagnosis, mortality, surgery*, therapy Humans Infant, Newborn Intestinal Atresia / diagnosis, mortality*, surgery* Intestines / physiology Male Parenteral Nutrition, Total / methods* Prenatal Diagnosis Retrospective Studies Risk Assessment Salvage Therapy / methods Severity of Illness Index Survival Analysis Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Open vs laparoscopic repair of congenital duodenal obstructions: a concurrent series.
Next Document: Resection-induced intestinal adaptation and the role of enteric smooth muscle.