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Ten-Year Review

J. Eugene Lewis, Jr., MD; Russell R. Kraeger, MD; Richard K. Danis, MD

AMA Arch Surg. 1973;107(2):218-222.

Abstract
Thirty-one infants with gastroschisis have been treated during the past ten years with a mortality of 32%. Improvement in management has resulted in only five deaths in the last 20 cases. The decrease in mortality seems directly related to prompt efficient preoperative treatment emphasizing preservation of body heat, decompression of the stomach with a nasogastric tube and evacuation of meconium with rectal irrigation. Stretching of the abdominal wall, gastrostomy, and primary closure is the treatment of choice in the perinatal group. In the antenatal group, coverage of the viscera with a polyester-reinforced silicone elastomer sheeting seems very effective in providing adequate coverage. The use of gas analyses, respiratory assistance, and parenteral alimentation allows support of the infant until the abdominal wall can be closed and orally administered nourishment established.

Author Affiliations
St. Louis

From the departments of surgery, Saint Louis University School of Medicine and Cardinal Glennon Memorial Hospital for Children, St. Louis.

Footnotes
Accepted for publication March 30, 1973.

Read before the 30th annual meeting of the Central Surgical Association, Toronto, Feb 23, 1973.

Reprint requests to Cardinal Glennon Memorial Hospital for Children, 1401 S Grand, St. Louis 63104 (Dr. Lewis).

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