Gastroschisis

[stnurse421]

I have just finished my Pedi. clinical rotation. During this rotation, I learned a condition that is new to me: Gastroschisis. I observed 2 patients with this condition. One of the patients was in the ICU and is basically dying due to liver failure. I think the gastroschisis was corrected but the liver is still not functioning. I was wondering if anyone has had any experience with this condition and what the outcome usually is. Thanks!:)

[prmenrs, RN]

It seems like lately there has been some sort of fire sale on gastroschises! These are difficult and complex patients, and they and their parents go through a LOT!

Some do well, some do not. I don't think I've ever met one that wasn't very crabby. Something about having your guts stuffed into an abdomen that is too small for them and didn't realize that's where they were supposed to be in the first place.

Do you know why the baby's liver was failing? Sometimes, the babies are on Hyperal for a long time, and that can affect the liver, causing a high direct bili, and other issues. If the liver was part of the abdominal contents misplaced, it may have had it's circulation compromised somewhere along the line.

Most on these kids get well enough to go home eventually, some a lot sooner than latter. We have one guy who's 5 months old, and hasn't left the NICU yet. To make matters worse, he has a 16y/o mom. Right now the plan is medically fragile foster-care placement, but he's going there on TPN and tube feedings. He's unusual! Most are about 6 weeks, I would GUESS.

How soon they get better depends on how careful you are starting feedings, how soon (and IFFF) you can get to full feeds.

[prmenrs, RN]

It seems like lately there has been some sort of fire sale on gastroschises! These are difficult and complex patients, and they and their parents go through a LOT!

Some do well, some do not. I don't think I've ever met one that wasn't very crabby. Something about having your guts stuffed into an abdomen that is too small for them and didn't realize that's where they were supposed to be in the first place.

Do you know why the baby's liver was failing? Sometimes, the babies are on Hyperal for a long time, and that can affect the liver, causing a high direct bili, and other issues. If the liver was part of the abdominal contents misplaced, it may have had it's circulation compromised somewhere along the line.

Most on these kids get well enough to go home eventually, some a lot sooner than latter. We have one guy who's 5 months old, and hasn't left the NICU yet. To make matters worse, he has a 16y/o mom. Right now the plan is medically fragile foster-care placement, but he's going there on TPN and tube feedings. He's fairly unusual! So is the poor little guy you saw. Most are about 6 weeks, I would GUESS.

How soon they get better depends on how careful you are starting feedings, how soon (and IFFF) you can get to full feeds.

[nurs4kids]

We have gastroschesis kids pretty often. Like prme, we seem to get them in groups. Other than occassional liver problems, usually caused by hyperal, they do pretty well.

[kids]

there are some interesting statistics at:

http://www.pedianet.com/news/illness/disease/disease.htm

[NicuGal, MSN, RN]

Depends on how much is out....but it is usually the long term HAL that does the liver in. :o We have only had a few that had no complications and headed out fairly quickly...most are in for a few months at least...then we send them up to comp care.