Gastroschisis Final Presentation
Gastroschisis Final Presentation
Gastroschisis Final Presentation
MO R
GOO D
General Objective
To present a case of an anterior
abdominal wall defect
Specific Objectives
To discuss the presentation, causes and prognosis of
gastroschisis
↓
8 hours prior to delivery
↓
BGHMC-ER
• single, live intrauterine pregnancy in cephalic
presentation, 33weeks AOG by fetal biometry
• posterior placenta Grade II-III maturity,
modified BPPS of 8/8, normohydramnios
• consider fetal abdominal defect probably
gastroschisis
19
Ballard Scoring
19
PHYSICAL EXAMINATION
Scaphoid,
(+) evisceration of
edematous intestines,
no sac, noted at the
paraumbilical area,
right, abdominal wall
defect measures 2.5
cms by 2.5 cms, with
intact umbilicus,
PHYSICAL
EXAMINATION
• Ano-genital:grossly male, testes
down, good rugae, patent anus
O
Gastroschisis Omphalocele
• covering is absent • covering is present
• located • located midline
paraumbilical,right
• 2-4cm • 2-15cm
• IUGR is common • IUGR is not common
• associated anomalies • associated anomalies
less common more common
• herniated organs are • herniated organs are
intestines intestine, stomach,
liver, spleen
textbook of surgery-schwartz
FLUID MANAGEMENT
• maintenance fluids + deficit
computed at 10-20cc/kg per number
of hours herniated organs exposed
• run PNSS in between transfusion of
FFP and albumin
• run maintenance fluid on a separate
line