Vanishing gastroschisis and short-bowel syndrome

Background: Gastroschisis occurs in 1 of every 4000 live births resulting i n a neonate with an abdominal wall defect that requires repair. Surgical co rrection has high survival rates. Case: An 18-year-old primigravida had a fetus with gastroschisis detected b y ultrasound performed for elevated maternal serum alpha-fetoprotein. Subse quent ultrasound found resolution of the classic sonographic features of ga stroschisis and evidence of intestinal obstruction. At birth, no obvious ab dominal wall defect was seen. Laparotomy was done because of clinical and r adiographic evidence of bowel obstruction, and we found significant bowel l oss that resulted in short-bowel syndrome. Conclusion: Gastroschisis diagnosed antenatally can resolve in utero causin g necrosis of portions of the small and large bowels, causing short-bowel s yndrome and increased morbidity and mortality. (Obstet Gynecol 2000;96:818- 9. (C) 2000 by The American College of Obstetricians and Gynecologists.).