Gastroenteritis belongs to the group of congenital defects of the anterior abdominal wall. For reasons not fully understood, the abdominal wall does not close properly during prenatal development. Through the opening left in them, the organs of the abdominal cavity come out - most often these are fragments of the intestine.

Contents:

  1. What is degeneration?
  2. Gastritis - causes, risk factors
  3. Gastritis - recognition
  4. Gastroenteritis - complications
  5. Gastroenteritis - treatment
  6. Gastroenteritis - prognosis
  7. Acquired degeneration

Gastroenteritisis a serious drawback, however, thanks to prenatal diagnosis and continuously improved treatment methods, the prognosis of patients with gastroenteritis has improved significantly over the years. Learn about gastroschisis, what complications can accompany gastroschisis, and how to treat gastroschisis.

What is degeneration?

Gastroenteritis, i.e. the displacement of the abdominal organs beyond the abdominal cavity, is a defect with a fairly typical clinical picture.

The opening in the anterior abdominal wall is in most cases located to the right of the navel, in its immediate vicinity. The diameter of this hole does not exceed a few centimeters, therefore usually fragments of the intestines of different lengths are wiped out.

It is much less common for other organs to leak out of the abdominal cavity (for example, the stomach or the liver).

Gastroenteritis should be differentiated primarily from a congenital hernia. However, there are typical features to distinguish these two drawbacks.

In the case of a hernia, the organs that extend beyond the abdominal cavity are always surrounded by the hernial sac. On the other hand, in gastritis, we see "bare" intestines outside the abdomen, devoid of any covering.

Defect of the abdominal wall in a hernia can reach considerable dimensions. Hernias are often accompanied by other birth defects that may also be genetic. Gastroenteritis, on the other hand, is most often an isolated defect.

The main problem with gastroenteritis is not the mere presence of the intestines outside the abdomen, as they can usually be put in the right place during surgery. It plays a much more important roleand how the gut functions outside of its physiological location.

As mentioned above, in gastroschisis (unlike a hernia) there is no layer or layer of tissue that isolates the intestines from the external environment. The anemiced intestine is therefore in direct contact with the amniotic fluid inside the uterus, which has an irritating effect on it.

The tissues of the intestine usually respond to such irritation with inflammation of varying severity. This inflammation is manifested primarily by swelling and hardening of the intestinal wall. Another important factor is the blood supply to the exaggerated intestine.

In a situation where the opening in the abdominal wall has a small diameter and becomes gradually tightened, there may be local pressure on the vessels and blood circulation disorders. This condition is called "closing gastrochisis" in the scientific literature. If left untreated, prolonged ischemia of the intestine can lead to segmental necrosis.

Gastritis - causes, risk factors

Despite many years of clinical observation, the cause of the abnormal development of the anterior abdominal wall, leading to gastroschisis, has still not been clearly identified.

At the stage of embryonic development, blood supply to cells or their inappropriate movement is likely to be disturbed. However, the course of these processes has not been fully understood, hence the methods of preventing gastroschisis are unknown to us.

The only confirmed observation is the fact that evisceration occurs more often in children of young mothers. The role of environmental factors (alcohol, cigarettes) is also increasingly emphasized.

Gastroenteritis is rarely a genetic defect.

Gastritis - recognition

Nowadays, the vast majority of cases of gastroschisis are diagnosed during prenatal examinations.

The ultrasound examination (USG) in the second trimester of pregnancy is of the greatest importance. A typical image of an ultrasound examination in the exfoliation is the slowly floating amniotic intestines in the cavity, not covered with a hernial sac.

Prenatal diagnosis of gastroschisis is an indication for the pregnant patient to undergo more frequent follow-up ultrasound examinations.

You should constantly monitor the condition of the exaggerated intestines - how much inflammation is there, if there is no obstruction, and if there is no ischemia and wall necrosis.

The intensification of inflammatory changes and a significant deterioration of the condition of the intestines may be an indication for an early termination of pregnancy.

Anyone like thatthe case is considered individually and requires consideration of the risk of possible complications of prematurity.

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Gastroenteritis - complications

Complications of gastroschisis include early, that is, appearing immediately after birth and being a direct result of the defect, and late, developing after the completion of surgical treatment and often chronic in nature.

  • early complications

Early complications of gastroschisis include the above-mentioned conditions associated with exposure of the intestine to the irritating effect of amniotic fluid and impaired blood supply. Thus, among the early complications of gastroschisis:

  • inflammation of the intestinal wall
  • ischemia of the intestine with subsequent necrosis and perforation
  • intestinal twist leading to intestinal obstruction and pathological distension of the intestine

Abnormalities in the embryonic development of the intestines may lead to intestinal atresia. On the other hand, the loss of the abdominal wall may be the gateway to infection and lead to infectious complications.

Newborns with congenital gastroenteritis often have a low birth weight. Preterm infants also have an increased risk of developing Necrotizing Enterocolitis (NEC).

  • late complications

Regardless of successful surgical treatment and the drainage of the intestines into the abdominal cavity, gastroschisis exposes the intestine to damaging factors at a very early stage in a child's life. Later, bowel function may be impaired because of this.

One of the most common abnormalities is malabsorption and their effects (poor weight gain, nutrient deficiencies). Among patients with congenital gastroschisis, gastrointestinal motility disorders and gastroesophageal reflux disease are also more frequently described.

Gastroenteritis - treatment

The basic method of treating gastroschisis is quite intuitive - the eviscerated organs should be returned to the inside of the abdominal cavity and the defect in the anterior abdominal wall should be closed. Ideally, surgery should be performed shortly after birth, which unfortunately is not always possible.

If the intestines are heavily inflamed or severely damaged, a multi-stage treatment may be required. The erupted organs can then be covered with special onescoatings of artificial materials that provide adequate insulation and healing conditions.

Regardless of the surgical treatment, you must always bear in mind the effects of the presence of an opening in the natural integuments of the body. Such a defect is a place of intense evaporation of water from the tissues, therefore the child must receive an adequate volume of intravenous fluids.

Lack of skin integuments also disturbs proper thermoregulation, therefore it is necessary to prevent the little patient from getting cold.

Finally, you should always be mindful of the risk of infectious complications - microbes can freely penetrate the opening into the body. For this reason, gastroschisis is usually associated with the use of prophylactic antibiotic therapy.

If the lack of bowel function prevents oral nutrition, periodic parenteral nutrition is introduced.

Gastroenteritis - prognosis

The prognosis for each gastroschisis is individual and depends on the degree of intestinal damage and the presence of complications. The survival rate of newborns with congenital gastroschisis has significantly improved over the years and is now over 90%.

Properly early (prenatal) diagnosis of the defect and its subsequent control play a very important role. Patients diagnosed with congenital gastroschisis are currently referred to specialist centers experienced in treating this type of defect.

After successful surgical treatment, they are under constant medical control in terms of digestive disorders and food absorption.

Acquired degeneration

The above text focuses on congenital evisceration, which is the result of abnormal embryonic development of the abdominal wall.

However, it is also worth mentioning the acquired gastroschisis, i.e. the removal of the abdominal organs beyond the abdominal cavity, most often as a result of a mechanical injury.

Acquired gastritis may also be a consequence of postoperative wound dehiscence after surgical procedures.

Treatment of the acquired form of gastroschisis does not differ from the congenital one - it requires an operation involving the removal of the eviscerated organs into the abdominal cavity and the proper closure of its integuments.

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About the authorKrzysztof BialaziteA medical student at Collegium Medicum in Krakow, slowly entering the world of constant challenges of the doctor's work. Especially interestedgynecology and obstetrics, paediatrics and lifestyle medicine. A lover of foreign languages, travel and mountain hiking.

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Category:

Gastrology