Re: Gastroschisis

Posted By HFHSM.D.-bb on February 26, 1998 at 23:38:59:

In Reply to: Gastroschisis posted by Angela Bibb on February 05, 1998 at 15:15:50:







: My son who is now 5 was born in 1992 with gastroschisis.  I still have concerns of continuing or reocurring problems.
Nicholas has always had great difficulty in having bowel movements, even with the help of medicated stool softeners.  
We are no longer with a specialist since he has aged and the average pediatrician is aware of what gastroschisis is, but
by no means an authority.  I guess I have either Mothers intuition telling me he is still having some side affects to the
surgery, or just plain old paranoia.  Is it possible for him to still be having problems?   As I stated, horrific bowel
movements, has just reached 40lbs., little to no appetite.  Has always vomitted easily when ill and had bad reflux until
age 1.  Where can I go to find an authority on this?  Or to at least put my mind at ease.  We live in Dallas and there has
to be at least 1 person who can fill in the blanks for me.
Thanks for any help you can give to me.
Angela Bibb



_____
February 21, 1998
Re:  Gastroschisis
Dear Angela Bibb:
     Gastroschisis is one of  the two common birth defects of the abdominal wall.  In this condition
there is a  hole in the abdomen just to the right of the navel that does not
involve the umbilical cord.  The hole permits the intestines to protrude or herniate from inside the
abdomen during development of the infant prior to birth.  As a result, there are dangers
at birth for mechanical twisting and blockage of the bowel as well as infection.  Surgery must
be performed at birth to return the bowel to its normal location and to correct the birth defect  in
the wall of the abdomen.  The operation is quite effective in treating the condition but some infants
and children are bothered by lingering problems after surgery.  First, as you experienced, gastroesophageal  reflux (i.e. the spontaneous movement of stomach acid and other contents from the stomach back up the swallowing tube or esophagus) can occur for an extended period of time.  Rarely, a kinking or adhesion of the bowel may occur and lead to partial blockage of the small intestine which may
predispose an infant or child  who has had gastroschisis to vomiting.  Lastly, there are sometimes other birth defects  present that may have gone undetected in the past but this is very unlikely.
     Since your child is now five years old, there may be other reasons for poor appetite and difficult
bowel movements besides the past history of gastroschisis.  Despite the other possibilities, the past
surgery is sufficient reason for a good general evaluation by a pediatric physician who is familiar
with all bowel conditions, including those occuring after the surgical repair of abdominal birth
defects.  In your sons case, the best physician would be a pediatric gastroenterologist who possibly
would work with your pediatric surgeon to answer your very good questions about your
childs current state of health and the potential need for any testing.  Since you live in Dallas, you may
try consulting Childrens Medical Center for the names of individuals you might obtain a referral to.
If you have any further questions about the above information, please feel free to consult with William M. Belknap, M.D, one of our Detroit experts in Pediatric Gastroenterology,.  Dr. Belknap can be reached
at phone number [phone].
This information is provided for informational purposes only.  It should not be interpreted as a consultation for a specific problem.  For specific information, please contact a physician to arrange an evaluation.
HFHSM.D.-bb
keywords: gastroschisis, hernia

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A related discussion, expiriences of mothers with gastrochisis was started.