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Gastroschisis
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Gastroschisis

Gastroschisis represents a full thickness defect of the anterior abdominal wall
The prolapse of small intestine seen in this case is typical
Note the absence of other abdominal viscera and a covering sac as is found in an Omphalocoele
(Description By:Martin Nadel, M.D. )
(Image Contrib. by: UCHC )
Abdominal Wall Defects (Congenital)
Etiology

Abdominal wall defects include omphalocele, gastroschisis, limb-body wall complex and prune-belly syndrome.
Although grouped together, their etiology and pathogenesis may vary.
Omphalocele is associated with other anomalies (50%); many have trisomy 18; neural-tube defects are also common.
Gastroschisis and limb body wall complex is not associated with other anomalies or chromosome abnormalities.
Prune-Belly syndrome is associated with intestinal abnormalities.
Pathogenesis

Omphalocele is a defect at the umbilicus.
Gastroschisis is a defect lateral to the midline; theories include either ischemia (interruption of the omphalomesenteric artery).
Limb-body wall complex (body stalk anomaly) is a major disruption which may be due to rupture of the amniotic sac with adhesion to the placenta. Ischemia is also invoked.
Prune-belly is theorized to result either from a defect in the "mesoderm" or secondary to abdominal distention.,
Epidemiology

Omphalocele most common; prune belly most abnormal.
Male=female
Associated with fetal loss.
General Gross Description

The intestine and other portions of the abdominal organs herniate omphalocele, limb-body wall complex and gastroschisis.
The major differentiation is the location of the defect (umbilical or lateral to the midline) and the associated anomalies.
General Microscopic Description

Little microscopic abnormality.
Clinical Correlation

Although frequently fatal in utero, gastroschisis and omphalocele can be repaired.
Morbidity and mortality revolve around associated abnormalities in the bowel and other organs.
References

Developmental Pathology of the Embryo and Fetus. Dimmick JE, Kalousek DK (eds). Philadelphia: Lippincott, 1992, pp. 527-9.
Abdominal Wall Defects (Congenital)
Synopsis by: Melinda Sanders M.D. (T89000M28100)[613]
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