Gastroschisis

Conclusion

The outcome for patients with gastroschisis has dramatically improved. Whereas the mortality was 80 to 90% three or four decades ago, the survival is now more than 90%. The improvement in outcome is related to the availability of intravenous nutrition and the use of staged closure when indicated. Late complications and mortality are related to sepsis either from an intra-abdominal or wound complication or from a central venous catheter placed for parental nutrition.

Once there is evidence of bowel function it is appropriate to begin enteral feeding. An elemental formula may be better tolerated. When the infant has reached adequate caloric intake enterally then discharge is appropriate.

In the absence of complications during the recovery from surgery and resolution of the bowel oedema, infants with gastroschisis usually reach goal feedings within 3–4 weeks. Long-term complications are unusual once the infants are discharged from the hospital.