Primary closure of gastroschisis aided by ileostomy: A new management approach for low resource settings

Background: The outcome of gastroschisis largely depends on place of birth. Prognosis is excellent with >95% survival in high income countries (HIC) while mortality remains high in low-income and middle-income countries (LMIC). Gastroschisis has nearly 100% mortality rate in our country, which ha...

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Autores principales:	Samuel Negash, Fisseha Temesgen
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2022
Materias:	Gastroschisis Silo Primary closure Global surgery Case report Pediatrics RJ1-570 Surgery RD1-811
Acceso en línea:	https://doaj.org/article/a309a50bf7d04dcd9345fe730b962ac3
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spelling	oai:doaj.org-article:a309a50bf7d04dcd9345fe730b962ac32021-12-04T04:34:12ZPrimary closure of gastroschisis aided by ileostomy: A new management approach for low resource settings2213-576610.1016/j.epsc.2021.102135https://doaj.org/article/a309a50bf7d04dcd9345fe730b962ac32022-01-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2213576621003560https://doaj.org/toc/2213-5766Background: The outcome of gastroschisis largely depends on place of birth. Prognosis is excellent with >95% survival in high income countries (HIC) while mortality remains high in low-income and middle-income countries (LMIC). Gastroschisis has nearly 100% mortality rate in our country, which has made it the most frustrating condition for pediatric surgeons. Case presentation: Recently we attempted a different approach for gastroschisis in order to improve the outcome. This entailed creating an ileostomy on the abdominal wall defect. In this paper we describe the first two neonates managed with this method in Ethiopia. The first case was a girl that presented on the 6th hour of life and the second was a boy that arrived to our hospital on the 24th hour of life. The results were encouraging as both of the children survived. This is a new treatment strategy which has not been previously reported. Conclusion: Ileostomy can aid primary closure of gastroschisis with minimal bowel resection. It also promotes early bowel function and initiation of feeding which is the most important factor for survival in these neonates. We believe this is the best management option for gastroschisis in LMIC.Samuel NegashFisseha TemesgenElsevierarticleGastroschisisSiloPrimary closureGlobal surgeryCase reportPediatricsRJ1-570SurgeryRD1-811ENJournal of Pediatric Surgery Case Reports, Vol 76, Iss , Pp 102135- (2022)
institution	DOAJ
collection	DOAJ
language	EN
topic	Gastroschisis Silo Primary closure Global surgery Case report Pediatrics RJ1-570 Surgery RD1-811
spellingShingle	Gastroschisis Silo Primary closure Global surgery Case report Pediatrics RJ1-570 Surgery RD1-811 Samuel Negash Fisseha Temesgen Primary closure of gastroschisis aided by ileostomy: A new management approach for low resource settings
description	Background: The outcome of gastroschisis largely depends on place of birth. Prognosis is excellent with >95% survival in high income countries (HIC) while mortality remains high in low-income and middle-income countries (LMIC). Gastroschisis has nearly 100% mortality rate in our country, which has made it the most frustrating condition for pediatric surgeons. Case presentation: Recently we attempted a different approach for gastroschisis in order to improve the outcome. This entailed creating an ileostomy on the abdominal wall defect. In this paper we describe the first two neonates managed with this method in Ethiopia. The first case was a girl that presented on the 6th hour of life and the second was a boy that arrived to our hospital on the 24th hour of life. The results were encouraging as both of the children survived. This is a new treatment strategy which has not been previously reported. Conclusion: Ileostomy can aid primary closure of gastroschisis with minimal bowel resection. It also promotes early bowel function and initiation of feeding which is the most important factor for survival in these neonates. We believe this is the best management option for gastroschisis in LMIC.
format	article
author	Samuel Negash Fisseha Temesgen
author_facet	Samuel Negash Fisseha Temesgen
author_sort	Samuel Negash
title	Primary closure of gastroschisis aided by ileostomy: A new management approach for low resource settings
title_short	Primary closure of gastroschisis aided by ileostomy: A new management approach for low resource settings
title_full	Primary closure of gastroschisis aided by ileostomy: A new management approach for low resource settings
title_fullStr	Primary closure of gastroschisis aided by ileostomy: A new management approach for low resource settings
title_full_unstemmed	Primary closure of gastroschisis aided by ileostomy: A new management approach for low resource settings
title_sort	primary closure of gastroschisis aided by ileostomy: a new management approach for low resource settings
publisher	Elsevier
publishDate	2022
url	https://doaj.org/article/a309a50bf7d04dcd9345fe730b962ac3
work_keys_str_mv	AT samuelnegash primaryclosureofgastroschisisaidedbyileostomyanewmanagementapproachforlowresourcesettings AT fissehatemesgen primaryclosureofgastroschisisaidedbyileostomyanewmanagementapproachforlowresourcesettings
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Primary closure of gastroschisis aided by ileostomy: A new management approach for low resource settings

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