Gastroschisis

11,524views

test

00:00 / 00:00

Gastroschisis

Pathology

Lower gastrointestinal tract disorders

Bowel obstruction
Intestinal adhesions
Volvulus
Gallstone ileus
Familial adenomatous polyposis
Peutz-Jeghers syndrome
Gardner syndrome
Juvenile polyposis syndrome
Colorectal polyps
Colorectal cancer
Colorectal polyps and cancer: Pathology review
Gastroschisis
Imperforate anus
Omphalocele
Meckel diverticulum
Intestinal atresia
Hirschsprung disease
Intestinal malrotation
Crigler-Najjar syndrome
Biliary atresia
Gilbert's syndrome
Dubin-Johnson syndrome
Rotor syndrome
Congenital gastrointestinal disorders: Pathology review
Gallstones
Biliary colic
Acute cholecystitis
Ascending cholangitis
Chronic cholecystitis
Gallstone ileus
Gallbladder cancer
Cholangiocarcinoma
Gallbladder disorders: Pathology review
Abdominal hernias
Femoral hernia
Inguinal hernia
Microscopic colitis
Crohn disease
Ulcerative colitis
Inflammatory bowel disease: Pathology review
Small bowel ischemia and infarction
Ischemic colitis
Alcohol-induced liver disease
Alpha 1-antitrypsin deficiency
Autoimmune hepatitis
Benign liver tumors
Budd-Chiari syndrome
Cholestatic liver disease
Cirrhosis
Cirrhosis: Pathology review
Hemochromatosis
Hepatic encephalopathy
Hepatitis
Viral hepatitis: Pathology review
Hepatocellular adenoma
Hepatocellular carcinoma
Jaundice
Jaundice: Pathology review
Neonatal hepatitis
Non-alcoholic fatty liver disease
Portal hypertension
Primary biliary cirrhosis
Primary sclerosing cholangitis
Reye syndrome
Wilson disease
Celiac disease
Lactose intolerance
Protein losing enteropathy
Short bowel syndrome (NORD)
Small bowel bacterial overgrowth syndrome
Tropical sprue
Whipple's disease
Malabsorption syndromes: Pathology review
Carcinoid syndrome
Pancreatic neuroendocrine neoplasms
Zollinger-Ellison syndrome
Neuroendocrine tumors of the gastrointestinal system: Pathology review
Appendicitis
Appendicitis: Pathology review
Diverticulosis and diverticulitis
Diverticular disease: Pathology review
Gastroenteritis
Irritable bowel syndrome
Gastrointestinal bleeding: Pathology review
Acute pancreatitis
Pancreatitis: Pathology review
Pancreatic pseudocyst
Chronic pancreatitis
Pancreatic cancer
Necrotizing enterocolitis
Intussusception
Anal fissure
Anal fistula
Hemorrhoid
Rectal prolapse

Peritoneum and peritoneal cavity

Assessments

Flashcards

0 / 6 complete

USMLE® Step 1 questions

0 / 1 complete

High Yield Notes

11 pages

Flashcards

Gastroschisis

0 of 6 complete

Questions

USMLE® Step 1 style questions USMLE

0 of 1 complete

A 26-year-old woman, G2P1, comes to the emergency department in active labor. She has not received prenatal care during this pregnancy. A 3500g boy is delivered by an uncomplicated vaginal delivery. His temperature is 36.7°C (98°F), pulse is 120/min, respirations are 40/min, and blood pressure is 85/60 mmHg. Physical examination shows low-set ears, micrognathia and clenched fingers. Abdominal examination shows a midline non-reducible mass covered by a whitish membrane. Which of the following is the most likely cause of this patient's abdominal findings?  

External References

First Aid

2024

2023

2022

2021

Gastroschisis p. 364

Transcript

Watch video only

Content Reviewers

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)