Presentation And Management Of Gastroschisis: Experience In 8 Years In Benin-City, Nigeria

Abstract

Congenital anterior abdominal wall defect occurs commonly and requires specialized management. Thirteen cases of gastroschisis treated at the University of Benin Teaching Hospital, Benin City over an 8-year period is presented. There were nine males and four females (male/female ratio 2.3:1). Time lag before presentation ranged between 5 and 36 hours (mean 16.8 ± 9.9 hours). Only six (46.15%) presented in the unit within 12 hours of birth, while seven (53.85%) presented after 12 hours with varying degrees of complications. Of the six that presented within 12 hours, one death (16.65%) was recorded whereas six deaths (85.71%) were recorded among those that presented after 12 hours (P = 0.0291, Fisher\'s exact). The causes of deaths were fluid and electrolytes derangement, hypothermia, overwhelming sepsis, respiratory failure and inanition. Two were too ill for surgical intervention and died during resuscitation. Eleven were operated between 4 and 8 hours on presentation. Of the Six that had digital stretching of abdominal cavity, gastric suctioning/rectal irrigation and primary abdominal closure, three died and three survived. The two who had bowel gangrene for which resection/anastomosis and primary abdominal closure were done, survived. Of the three that had improvised prosthetic silo closure, two died and one survived. Overall, six (46.2%) survived while mortality of seven (53.8%) was recorded. This study shows that delay in presentation resulted in high morbidity and mortality rates.

Keywords: Gastroschisis, Congenital, Abdominal wall defect)

Sahel Medical Journal Vol. 10 (4) 2007: pp. 115-118