Department of Obstetrics, Saint-Luc University Hospital, Brussels, Belgium.
Department of Pediatric, Saint-Luc University Hospital, Brussels, Belgium.
Eur J Obstet Gynecol Reprod Biol. 2018 Sep;228:186-190. doi: 10.1016/j.ejogrb.2018.06.028. Epub 2018 Jun 19.
We report a case of vanishing gastroschisis visualized by antenatal ultrasound with a 7-year long term follow-up. Currently, the child is still dependent on daily parenteral nutrition with no signs of hepatotoxicity. To our knowledge, it's the fourth case with a long-term follow-up. Vanishing gastroschisis is a rare complication of gastroschisis. However, physicians should be aware of it because its prognosis is worse than classical gastroschisis. When a vanishing gastroschisis is visualized or suspected by antenatal ultrasound, prenatal counseling is required with explanations about the risk of short bowel syndrome, the need of parenteral nutrition and related complications (inflammatory colitis, sepsis, liver failure and organ transplant). Mortality rate was initially around 93%, and dropped to 27% after the years 2000 (versus 10% for classical gastroschisis). After birth, all children will require surgery, and sometimes autologous gastro-intestinal reconstruction. Most survivors (68%) could be taken off the TPN. Unfortunately, long-term outcomes for children with vanishing gastroschisis are still missing in current literature.
我们报告了一例产前超声可见的消失性腹裂，并进行了长达 7 年的长期随访。目前，患儿仍依赖每日肠外营养，无肝毒性迹象。据我们所知，这是第四例长期随访的病例。消失性腹裂是腹裂的一种罕见并发症。然而，由于其预后比经典型腹裂更差，医生应该对此有所认识。当产前超声可见或疑似消失性腹裂时，需要进行产前咨询，并解释短肠综合征的风险、肠外营养的必要性以及相关并发症（炎症性结肠炎、败血症、肝功能衰竭和器官移植）。死亡率最初约为 93%，2000 年后降至 27%（而经典型腹裂为 10%）。出生后，所有患儿都需要手术，有时还需要进行自体胃肠重建。大多数幸存者（68%）可以停用 TPN。不幸的是，目前文献中仍缺乏对消失性腹裂患儿的长期结局的报道。
