Gastroschisis

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Gastroschisis

GI Phase 2

GI Phase 2

Cleft lip and palate
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Temporomandibular joint dysfunction
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Gastroschisis
Imperforate anus
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Hirschsprung disease
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Intussusception
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Congenital gastrointestinal disorders: Pathology review
Esophageal disorders: Pathology review
GERD, peptic ulcers, gastritis, and stomach cancer: Pathology review
Inflammatory bowel disease: Pathology review
Malabsorption syndromes: Pathology review
Diverticular disease: Pathology review
Appendicitis: Pathology review
Gastrointestinal bleeding: Pathology review
Colorectal polyps and cancer: Pathology review
Pancreatitis: Pathology review
Gallbladder disorders: Pathology review
Jaundice: Pathology review
Viral hepatitis: Pathology review
Cirrhosis: Pathology review
Laxatives and cathartics
Antidiarrheals
Acid reducing medications

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With gastroschisis, gastro- refers to the gastrointestinal tract, and -schisis refers to separation; so in gastroschisis, the anterior abdominal wall fails to close and remains open or separated throughout fetal development, and this results in a newborn’s abdominal organs, often the intestines, protruding out and being exposed to the outside environment.

Now, during the fourth week of fetal development, the embryo starts to change shape from a flat, three-layer disc to something closer to a cylinder, called embryonic folding.

Looking at the embryo in the horizontal plane, the two lateral folds eventually come together and close off at the midline, except for one tiny spot where the umbilical cord connects the fetus to the placenta.

That opening later becomes the umbilicus, also known as the belly button.

This folding allows for the formation of the gut within the abdominal cavity.

With gastroschisis, those lateral folds don’t close all the way, essentially leaving an opening in the abdominal wall.

The hole almost always extends through the rectus muscle to the right of the umbilicus, although it’s not really known why it tends to be on the right side.

Whatever the reason is, this opening allows the developing organs to protrude through into the amniotic sac.

Exposing the abdominal organs to amniotic fluid can sometimes cause the intestines to get irritated and inflamed, which can lead to malabsorption issues.

Following delivery in gastroschisis, the bowels are exposed and they’re not covered by a peritoneal layer.

Sources

  1. "Robbins Basic Pathology" Elsevier (2017)
  2. "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
  3. "Pathophysiology of Disease: An Introduction to Clinical Medicine 8E" McGraw-Hill Education / Medical (2018)
  4. "CURRENT Medical Diagnosis and Treatment 2020" McGraw-Hill Education / Medical (2019)
  5. "Gastroschisis: A State-of-the-Art Review" Children (2020)
  6. "Epidemiology, management and outcome of ultrashort bowel syndrome in infancy" Archives of Disease in Childhood - Fetal and Neonatal Edition (2017)