Midgut Atresia and Spontaneously Closed Gastroschisis: Support for a Mechanical Explanation

Introduction

Neonates with a prenatal diagnosis of gastroschisis but born without any abdominal wall defect have midgut atresia. The condition is rare, and most reported cases died as a result of short bowel syndrome [1]. We describe a case with gastroschisis diagnosed at 19 weeks’ gestation that resolved spontaneously in utero. The boy was born without an abdominal wall defect, but had midgut atresia and presented after 2 days with ileus. After short small bowel resection and primary anastomosis he is thriving without parenteral nutrition.

It has been suggested that the abdominal wall defect in gastroschisis is caused by intrauterine vascular incidents. As proposed by others [1], the present case indicates an active closure process inherent in the defect, and we speculate that gastroschisis could be the result of a premature attempt at wall closure and/or delayed midgut retraction with subsequent vascular compression.

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