Gastroschisis and omphalocele are among the group of congenital anomalies most frequently encountered by pediatric surgeons. Their combined incidence is 1 in 2,000 births; hence, a pediatric surgeon sees twice as many babies with abdominal wall defects as babies with esophageal atresia and a tracheoesophageal fistula.
Although pediatric surgeons and neonatologists initially treat these babies, pediatricians should become familiar with the clinical spectrum of abdominal wall defects so that they are prepared to care for these children. If the baby's abdomen was closed during the neonatal period, routine pediatric care may suffice; however, if the abdominal wall defect was one component of a multifaceted anomaly, further care by specialists who are familiar with the child's particular problems may be required.
A baby who is born with gastroschisis may have associated malabsorption, either from in utero injury to the intestine or partial bowel obstruction. Anomalies of intestinal fixation accompany the abdominal wall defects, and midgut volvulus is possible. Atypical appendicitis may occur, if the abnormally located appendix was not removed. In addition, these children may have gastroesophageal reflux, andHirschsprung disease may complicate their clinical course.
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