Gastroschisis: Abd closure pulm eff


Closure of the abdominal wall defect in gastroschisis can cause decreased diaphragmatic excursion and compression of the lungs, with the development of abdominal compartment syndrome (ACS).  Pulmonary compliance decreases, and an increase in airway pressures can be seen during positive pressure ventilation.

In an effort to minimize the above effects, different management strategies for the correction of the defect have been explored.  Correction of the defect is considered in three main categories – primary closure on day 1 of life, construction of a surgical silo with secondary closure thereafter, and use of a preformed silo with reduction of abdominal contents over a period of a few days prior to surgical closure.  The best management course is an area of ongoing research within pediatric surgery.


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Emily Knipper, MD