Surgical conditions in gastroschisis with feeding intolerance after abdominal closure

Abstract

OBJECTIVE

To identify the surgical conditions in patients with gastroschisis with feeding intolerance after abdominal closure.

METHODS

This study was a retrospective case review by verifying and reviewing medical record of those with the diagnosis of gastroschisis between January 2014 and December 2016 at Khon Kaen Hospital, Thailand. All were identified using the hospital inpatient inquiry system with the International Statistical Classification of Diseases and Related Health Problems (ICD) 10 with the code Q79.3. The patients with feeding intolerance were later identified. The surgical conditions and their managements were described.

RESULTS

There were 37 gastroschisis patients; 24 males and 13 females. Their median gestational age was 35 weeks (range, 23 to 39), and median birth weight was 2,200 grams (range, 1300 to 3460). Nineteen of them underwent the primary closure of abdominal wall defects while 17 patients had two-stage repair with silo operation. There were five cases with feeding intolerance requiring additional operations following the abdominal closure. All were caused by mechanical gut obstruction including adhesion band, Hirschsprung's disease, neuronal intestinal dysplasia, jejunoileal atresia and intestinal necrosis at birth.

CONCLUSION

In gastroschisis patients with feeding intolerance after the abdominal closure, mechanical gut obstruction were susupected, additional operations were applied.