Abstract

Gastroschisis (GS) is one of the congenital abdominal wall defects, in which the bowel has prolapsed without a covering through a defect adjacent to (and nearly always to the right of) an otherwise normal umbilicus. Proper management of such cases gives them the opportunity to survive and thrive. In this chapter, simplified flowcharts for the initial management of GS, surgical intra-operative decisions and post-operative active follow-up of such cases will be presented and discussed. The first flowchart will discuss how to deal with a GS case from birth till the operative theatre, while the second flowchart will take the lead to guide the surgeon with the available surgical options and how to choose the suitable one for the case. Finally, the post-operative active follow-up fluid management and possible complications are discussed.

Keywords: gastroschisis, AWDs, fluid management, LMIC, complications

### 1. Introduction

Gastroschisis (GS) or more aptly "laparoschisis" is a congenital abdominal wall defect (AWD) leading to herniation of the gut more commonly to the right of the umbilical cord (Figure 1). It differs from other AWDs in causality, risk factors, and associated anomalies [1–3].

GS incidence is increasing worldwide [4, 5] and is estimated around 1 in 2200 live births [6, 7]. Antenatal scans detect most cases [8], survival in developed countries is excellent [7] and apart from some gastrointestinal dysfunction, longterm problems are rare [9].

This chapter is dedicated to discuss in simplified flowchart-form the initial, operative and post-operative management of GS with emphasis on low-resource settings. In addition it aims to outline salient topics such as fluid management and complications.
