Two Cases of Left-sided Gastroschisis

Abstract

Classically, gastroschisis is a right-sided periumbilical abdominal wall defect; left-sided gastroschisis is rare. Case 1: A female infant was delivered at 35 gestational weeks by cesarean section. Her birth weight was 2,606 g. She had an abdominal wall defect on the left side of the umbilical cord, which was diagnosed as left-sided gastroschisis. She showed no merger malformations. We performed siloplasty at 0 days old and abdominal wall closure at 10 days old. Her postoperative course was uneventful. Case 2: A male infant was delivered at 36 gestational weeks by cesarean section. His birth weight was 2,014 g. He had an abdominal wall defect on the left side of the umbilical cord, which was diagnosed as left-sided gastroschisis. He showed no merged malformations. We performed siloplasty at 0 days old and abdominal wall closure at 6 days old. His postoperative course was uneventful. No significant complications other than umbilical hernia were present. Left-sided gastroschisis has been observed to be predominant in females and is typically associated with extraintestinal anomalies. Similarly to right-sided gastroschisis, the primary or staged closure is selected depending on the case; for left-sided gastroschisis, abdominal wall closure is selected. In general, left-sided gastroschisis has an equally good prognosis as right-sided gastroschisis, but it depends on the presence of merged malformations and complications. The knowledge of left-sided gastroschisis is clinically useful, because of the high incidence of extraintestinal congenital malformations. The cause of gastroschisis is controversial, and studies on left-sided gastroschisis will help clarify the cause.