Gastroschisis is a defect in the formation of the abdominal wall that allows the abdominal contents to remain outside the abdomen. It is a focal defect believed to result during absorption of the right umbilical vein. There are few associated abnormalities. The surgical goal is to return the viscera to the abdominal cavity as soon as possible.
At birth, the diagnosis of gastroschisis is obvious, but it can be confused with a ruptured omphalocele. The location of the defect to the right of the normal umbilicus and the lack of a sac make the diagnosis. It is critical to adequately resuscitate the child as fluid losses from the exposed bowel can quickly lead to hypovolemia. A saline-soaked guaze dressing and plastic wrap are helpful.
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