Giant Gastroschisis with Complete Liver Herniation: A Case Report of Two Patients
Introduction. There are no reported survivors of gastroschisis with complete liver herniation. We describe a case report of two patients, one of whom survived. Case #1. The patient was born with gastroschisis and herniation of the entire liver. Along with silo placement, the abdominal fascia was att...
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Wiley
2019-01-01
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| Series: | Case Reports in Surgery |
| Online Access: | http://dx.doi.org/10.1155/2019/4136214 |
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| author | Wendy Jo Svetanoff Benjamin Zendejas Farokh R. Demehri Alex Cuenca Bharath Nath C. Jason Smithers |
| author_facet | Wendy Jo Svetanoff Benjamin Zendejas Farokh R. Demehri Alex Cuenca Bharath Nath C. Jason Smithers |
| author_sort | Wendy Jo Svetanoff |
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| description | Introduction. There are no reported survivors of gastroschisis with complete liver herniation. We describe a case report of two patients, one of whom survived. Case #1. The patient was born with gastroschisis and herniation of the entire liver. Along with silo placement, the abdominal fascia was attached to an external traction system for growth. Complete closure was achieved at 5 months. Due to pulmonary hypoplasia, high-frequency ventilation was required. The patient is doing well, on a home ventilator wean, at 20 months. Case #2. The patient was born prematurely with gastroschisis, total liver herniation, and a defect extending to the pericardium. A silo was attached to the fascia to provide growth of the abdominal cavity. The patient developed respiratory failure, diffuse anasarca, and renal failure. She died at 38 days of life. Discussion. We report the first survivor of gastroschisis with complete liver herniation, contrasting it with a death of a similar case. The associated pulmonary hypoplasia may require long-term ventilation, the inflammatory response can lead to anasarca, and renal injury can occur from acute-on-chronic compartment syndrome. Conclusion. External fascial traction systems can help induce growth of the abdominal wall, allowing closure of the challenging abdomen. While critical care management is complex, survival is possible. |
| format | Article |
| id | doaj-art-9caeaf1e5f9a47a4a0bdf82b389ce733 |
| institution | Kabale University |
| issn | 2090-6900 2090-6919 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
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| series | Case Reports in Surgery |
| spelling | doaj-art-9caeaf1e5f9a47a4a0bdf82b389ce7332025-02-03T05:53:01ZengWileyCase Reports in Surgery2090-69002090-69192019-01-01201910.1155/2019/41362144136214Giant Gastroschisis with Complete Liver Herniation: A Case Report of Two PatientsWendy Jo Svetanoff0Benjamin Zendejas1Farokh R. Demehri2Alex Cuenca3Bharath Nath4C. Jason Smithers5Department of General Surgery, Boston Children’s Hospital, 300 Longwood Ave, Fegan 3, Boston MA 20115, USADepartment of General Surgery, Boston Children’s Hospital, 300 Longwood Ave, Fegan 3, Boston MA 20115, USADepartment of General Surgery, Boston Children’s Hospital, 300 Longwood Ave, Fegan 3, Boston MA 20115, USADepartment of General Surgery, Boston Children’s Hospital, 300 Longwood Ave, Fegan 3, Boston MA 20115, USADepartment of General Surgery, Boston Children’s Hospital, 300 Longwood Ave, Fegan 3, Boston MA 20115, USADepartment of General Surgery, Boston Children’s Hospital, 300 Longwood Ave, Fegan 3, Boston MA 20115, USAIntroduction. There are no reported survivors of gastroschisis with complete liver herniation. We describe a case report of two patients, one of whom survived. Case #1. The patient was born with gastroschisis and herniation of the entire liver. Along with silo placement, the abdominal fascia was attached to an external traction system for growth. Complete closure was achieved at 5 months. Due to pulmonary hypoplasia, high-frequency ventilation was required. The patient is doing well, on a home ventilator wean, at 20 months. Case #2. The patient was born prematurely with gastroschisis, total liver herniation, and a defect extending to the pericardium. A silo was attached to the fascia to provide growth of the abdominal cavity. The patient developed respiratory failure, diffuse anasarca, and renal failure. She died at 38 days of life. Discussion. We report the first survivor of gastroschisis with complete liver herniation, contrasting it with a death of a similar case. The associated pulmonary hypoplasia may require long-term ventilation, the inflammatory response can lead to anasarca, and renal injury can occur from acute-on-chronic compartment syndrome. Conclusion. External fascial traction systems can help induce growth of the abdominal wall, allowing closure of the challenging abdomen. While critical care management is complex, survival is possible.http://dx.doi.org/10.1155/2019/4136214 |
| spellingShingle | Wendy Jo Svetanoff Benjamin Zendejas Farokh R. Demehri Alex Cuenca Bharath Nath C. Jason Smithers Giant Gastroschisis with Complete Liver Herniation: A Case Report of Two Patients Case Reports in Surgery |
| title | Giant Gastroschisis with Complete Liver Herniation: A Case Report of Two Patients |
| title_full | Giant Gastroschisis with Complete Liver Herniation: A Case Report of Two Patients |
| title_fullStr | Giant Gastroschisis with Complete Liver Herniation: A Case Report of Two Patients |
| title_full_unstemmed | Giant Gastroschisis with Complete Liver Herniation: A Case Report of Two Patients |
| title_short | Giant Gastroschisis with Complete Liver Herniation: A Case Report of Two Patients |
| title_sort | giant gastroschisis with complete liver herniation a case report of two patients |
| url | http://dx.doi.org/10.1155/2019/4136214 |
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