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Understanding Gastroschisis: Causes, Risks, and Differential Diagnosis of Abdominal Wall Defects

Gastroschisis is a congenital defect characterized by herniation of bowel loops and abdominal organs through a gap in the abdominal wall, typically located to the right of the umbilical cord. This condition arises when the lateral body folds fail to fuse during the 4th week of development. Risk factors include high-risk pregnancies, young maternal age, smoking, and factors contributing to low birth weight. Differential diagnoses include omphalocele and other abnormalities such as bladder exstrophy and the limb-body wall complex. Early diagnosis through ultrasound is vital for management.

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Understanding Gastroschisis: Causes, Risks, and Differential Diagnosis of Abdominal Wall Defects

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  1. Definition • Herniation of bowel loops & other abdominal organs through a defect in the abdominal wall w/ no associated covering /sac • Defect just to the right of the umbilical cord

  2. Embryology • During the 4th week of development, the lateral body folds move ventrally and fuse in the midline to form the anterior body wall. • Incomplete fusion defect that allows abdominal viscera to protrude through the abdominal wall. • The bowel typically herniates through the rectus muscle, lying to the right of the umbilicus.

  3. Risk Factors • High-risk pregnancies complicated by infection • young maternal age • Smoking / drug abuse • anything that contributes to low birth weight can increase the incidence of gastroschisis

  4. Differential Diagnosis ANTS & CLAUDING— may table form yung ddx see if pwede na o congested pa din Thanks!!! P.S. Same lang yung table at di table form Pili lang k..thanks again

  5. Omphalocele • a defect in the anterior abdominal wall with extrusion of abdominal organs. • covered by a membrane (consisting of an outer layer of amnion and an inner layer of peritoneum) with the cord inserting through these covering. • In contrast with gastroschisis there is a high association with other malformations and chromosomal abnormalities

  6. Congenital hernia of the abdominal wallan extra-abdominal mass on the right of the normal umbilical cord insertion. • Bladder extrophy: abdominal wall defect of the infra-umbilical region in which bladder mucosa is exposed. Ultrasound findings are absence of a fluid-filled intrapelvic bladder and a soft tissue mass seen at the lower abdomen. • Cloacal dystrophy: also known as OEIS complex: association of omphalocele, bladder extrophy, imperforate anus and spina bifida.

  7. Limb body wall complex (body stalk anomaly): a set of disruptive abnormalities characterized by a severe body-wall defect (thorax, abdomen or both), evisceration of the abdominal organs into an amnioperitoneal sac and a shortened or absent umbilical cord • Pentalogy of Cantrell: large abdominal wall defect characterized by omphalocele, ectopia cordis and disruption of the distal sternum, anterior diaphragm and diaphragmatic pericardium. It appears on ultrasound as a large thoracoabdominal wall defect containing the heart and much of the abdominal contents • Beckwith Wiedeman syndrome: omphalocele, organomegaly (liver, splenic and renal enlargement), macroglossia and polyhydramnios

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