GASTROSQUISIS CON CIERRE PRIMARIO: REPORTE DE CASO
Date
Journal Title
Journal ISSN
Volume Title
Publisher
Rev. Méd. La Paz
Abstract
La gastrosquisis es un defecto de la pared ventral con protrusión visceral del lado derecho la cual no se encuentra cubierta por membranas, con una incidencia de 4.5 a 5 por cada 10, 000 nacidos vivos. El objetivo de este reporte de caso es identificar los criterios de complejidad para predecir una gastrosquisis simple o compleja y su predicción para realizar cierre primario. Se atendió una paciente primigesta de 17 años, feto con gastrosquisis diagnosticado desde el primer trimestre de embarazo, acudió para resolución del embarazo en tercer trimestre con trabajo de parto en fase latente, como hallazgos relevantes en la ecografía se encontró Restricción de Crecimiento Intrauterino (RCIU) tipo 1 y un defecto ventral de 20 mm con prolapso intestinal, engrosamiento de 2 mm y distensión de 28 mm, sin criterios de complejidad. Se realizó cesárea tipo Kerr, obteniendo recién nacido con prolapso intestinal sin isquemia, se realizó cierre primario con técnica SIMIL.EXIT. Es importante realizar un diagnóstico prenatal oportuno en pacientes con gastrosquisis e identificar los criterios de complejidad para predecir el tipo de cierre del defecto en manejo conjunto con cirugíaa pediátrica y tener un mejor pronóstico para el recién nacido.
Gastroschisis is a defect of the ventral wall with visceral protrusion of the right side which is not covered by membranes, with an incidence of 4.5 to 5per 10,000 live births. The objective of this case report is to identify the complexity criteria to predict a simple or complex gastroschisis and its prediction to perform primary closure. A 17-year-old primigestational patient was attended, fetus with gastroschisis diagnosed since the first trimester of pregnancy, attended for resolution of pregnancy in third trimester with labor in latent phase, as relevant findings in the ultrasound were found Intrauterine Growth Restriction (IUGR) type 1 and a ventral defect of 20 mm with intestinal prolapse, thickening of 2 mm and distension of 28 mm, without complexity criteria. Kerr cesarean section was performed, obtaining a newborn with intestinal prolapse without ischemia, primary closure was performed with SIMIL.EXIT technique. It is important to perform a timely prenatal diagnosis in patients with gastroschisis and to identify the complexity criteria to predict the type of closure of the defect in conjunction with pediatric surgery and to have a better prognosis for the newborn.
Gastroschisis is a defect of the ventral wall with visceral protrusion of the right side which is not covered by membranes, with an incidence of 4.5 to 5per 10,000 live births. The objective of this case report is to identify the complexity criteria to predict a simple or complex gastroschisis and its prediction to perform primary closure. A 17-year-old primigestational patient was attended, fetus with gastroschisis diagnosed since the first trimester of pregnancy, attended for resolution of pregnancy in third trimester with labor in latent phase, as relevant findings in the ultrasound were found Intrauterine Growth Restriction (IUGR) type 1 and a ventral defect of 20 mm with intestinal prolapse, thickening of 2 mm and distension of 28 mm, without complexity criteria. Kerr cesarean section was performed, obtaining a newborn with intestinal prolapse without ischemia, primary closure was performed with SIMIL.EXIT technique. It is important to perform a timely prenatal diagnosis in patients with gastroschisis and to identify the complexity criteria to predict the type of closure of the defect in conjunction with pediatric surgery and to have a better prognosis for the newborn.
Description
Vol. 31, No. 1