Flores-Fenlon Nicole, Shafer Grant, Awan Saeed, Ahmad Irfan
Division of Neonatology, Children's Hospital of Orange County, Orange, California.
Division of Neonatal Medicine, University of California, Irvine School of Medicine, Irvine, California.
AJP Rep. 2023 Mar 15;13(1):e17-e20. doi: 10.1055/a-2028-7890. eCollection 2023 Jan.
Gastroschisis is a congenital, typically isolated, full-thickness abdominal wall defect in which the abdominal contents, usually only the small intestine, remain outside the abdominal cavity. It is commonly detected on fetal ultrasonography, and has generally excellent survival and outcomes, though these can be decreased in cases of complicated gastroschisis. We present the case of a female infant with a prenatal diagnosis of gastroschisis who required a prolonged and complex resuscitation after delivery. In addition to her gastroschisis, she presented with a history and physical examination consistent with severe hypoxic-ischemic encephalopathy and was treated with therapeutic hypothermia (TH) without further compromise to her bowel. In addition, careful consideration of neuroprotection, fluid status, bowel viability, and hemodynamics were undertaken in her care. She was discharged home on full enteral feeds, with only mild language and gross motor delays at 6 months of age. To our knowledge, there are no reports in the literature of the use of TH in the setting of unrepaired simple gastroschisis.
腹裂是一种先天性的、通常为孤立性的全层腹壁缺损，腹腔内容物（通常仅为小肠）留在腹腔外。它通常在胎儿超声检查时被发现，一般预后良好，存活率高，不过在复杂腹裂病例中这些情况可能会变差。我们报告一例产前诊断为腹裂的女婴，其出生后需要长时间的复杂复苏。除腹裂外，她的病史和体格检查结果符合重度缺氧缺血性脑病，接受了亚低温治疗（TH），且肠道未受到进一步损害。此外，在对她的护理过程中，还仔细考虑了神经保护、液体状态、肠道活力和血流动力学等因素。她在完全经口喂养后出院，6个月大时仅有轻微的语言和粗大运动发育迟缓。据我们所知，文献中尚无关于在未修复的单纯腹裂情况下使用亚低温治疗的报道。
