What is gastroschisis?
Gastroschisis is an opening in the abdominal wall - the muscles and skin of the abdomen — that appears during fetal development. Normally, during early development, the intestines, stomach and liver protrude to the outside of the body. As the fetus grows, these organs are "pulled in" and the abdominal wall forms around them. In gastroschisis, the stomach and small and large intestines are not enclosed in the abdominal wall and appear outside of the body.
The opening may become smaller and may tighten around the intestine, or the bowel may twist around itself. This can lead to poor function of the bowel after your baby is born, as well as long-term feeding problems. The cause of is still unknown.
How we care for gastroschisis
At Boston Children's Hospital, we specialize in the treatment of children with gastroschisis in our Center for Advanced Intestinal Rehabilitation (CAIR), which includes a team of experts with decades of experience in caring for children with intestinal problems and their families. Our specialists include:
- physicians trained in surgery, gastroenterology and nutrition
- registered dieticians
- nurse practitioners
- social worker
Our areas of innovation for gastroschisis
The team at Boston Children's actively participates in research focused on the treatment and understanding of gastroschisis and has made major contributions to the field. Two of our physicians developed the serial transverse enteroplasty procedure (STEP), a surgical technique developed that has been used on patients who have a related condition called short bowel syndrome.
Gastroschisis | Diagnosis & Treatments
How is gastroschisis diagnosed?
This condition is often diagnosed prenatally, by ultrasound. Pregnant women may be referred to a neonatal surgeon.
How is gastroschisis treated?
If your baby's lungs are mature, your doctor may want to deliver your baby at 36 weeks. Therefore, a Caesarean delivery may be necessary.
After delivery, your baby will receive intravenous (IV) fluids. The intestines will be placed in a clear surgical plastic bag and your baby will be brought to the neonatal intensive care unit. Surgery to repair the opening and return the intestines to their proper place will take place within 12 to 24 hours. If the opening is small, the repair can be done in one step. If the opening is larger, it may need to take place slowly over three to five days.
Most babies recover well. Recovery time in the hospital includes feeding your baby through IV. In some cases, a baby will develop a condition known as short bowel syndrome, which is characterized by diarrhea, very slow weight gain and deficiencies of important vitamins and minerals. In this instance, your baby may require a longer course of IV nutrition.