Gastroschisis (gast-roh-SKEE-sis) is when a baby is born with the intestines
sticking out through a hole in the belly wall near the umbilical cord. Sometimes other
organs also stick out. It's a life-threatening condition that needs treatment right
away.
What Happens With Gastroschisis?
During normal prenatal development: As the organs inside an unborn baby's belly
form, the intestines push out through a hole in the belly wall. Later, they twist
and move back inside the belly, and the hole closes.
When a baby has gastroschisis: The intestines stay outside of the belly, keeping
the hole in the belly wall from closing. When the baby is born, the intestines are
visible. Often, they're damaged from weeks of soaking in the amniotic fluid in the
womb (uterus). The baby needs treatment right away.
What Are the Signs & Symptoms of Gastroschisis?
A baby born with gastroschisis will lose heat and
water very quickly from the intestines, causing:
Doctors don't know why gastroschisis happens. It is probably due to a combination
of genetic and environmental factors. During pregnancy, the intestines grow correctly
at first, but then do not go back inside the belly as they usually do.
Gastroschisis is more likely when the mother:
is under age 20
smokes during her pregnancy
drinks alcohol
Gastroschisis is more common now than it has been in previous decades, but doctors
don't know why.
How Is Gastroschisis Diagnosed?
A pregnant woman doesn't have any symptoms during pregnancy when her baby has gastroschisis.
But doctors might find gastroschisis before the baby is born when the mother has a:
If needed, they arrange for surgery soon after birth. In some cases, doctors must
repair gastroschisis with surgery for the intestines to survive.
If the mom doesn't go into labor on her own, doctors will give medicines to induce labor.
A baby with gastroschisis is fed through an
(IV) line because the intestine:
is swollen
can't fit in the baby's belly because of the swelling
doesn't absorb nutrients well when it's outside of the body
may have been damaged during pregnancy or birth
The care team puts the baby's lower half and the intestines in a special plastic
bag to:
keep the intestines from losing too much water
reduce heat loss
Often, the intestines don't fit in the belly because they're swollen. If so, the
surgeon usually arranges the intestines in a bag called a silo to:
let the water move out of the intestines so they shrink to normal size
allow the intestines to slowly move into the belly
The care team gradually tightens the silo as the intestines return to normal size.
Putting the intestines back into the belly with a silo usually takes about 3–4 days,
but may take longer.
What Else Should I Know?
The intestines of a child with gastroschisis may not work well even after they're
returned to the belly. So moving a baby from IV feeding to feeding by mouth can take
a long time. It may be a month or longer before the intestines can absorb nutrients
well enough to support the baby without help from the IV.
After the pediatric surgeon returns the intestines to the belly, the newborn:
may need help breathing because the intestines and other organs in the belly push
up on the breathing muscle (
)
usually stays in the hospital for several weeks
gets IV feeding until the intestines heal
slowly begins to digest pumped breast milk or formula, which can be given through:
a nose-to-stomach (nasogastric, NG) feeding tube
mouth-to-stomach (orogastric, OG) feeding tube
a bottle
A baby whose healthy small intestine is much shorter than usual can have a rare
condition called short gut syndrome (or short bowel syndrome).
This means the baby can't absorb enough nutrition from digested food to grow and thrive.
This can happen if:
The gastroschisis abdominal wall defect partially closes and restricts blood flow
to the intestine.
The intestine twists and cuts off its own blood supply.
A baby with short gut syndrome needs extra nutritional support and other medical
care.
Looking Ahead
Almost all babies born with gastroschisis survive if they receive prompt treatment.
The medical challenges of gastroschisis can be stressful for your child and you.
But you're not alone. The care team will work together to help manage problems, and
to support your family. You can also ask about support groups, or visit online sites
such as:
