Digestive and Gastrointestinal Conditions

Gastroschisis

What is gastroschisis?

Gastroschisis (gas-troh-SKEE-sis) occurs when there is a hole in the muscles and skin that cover a baby’s belly. The baby's intestines – and sometimes other organs – poke through this hole, leaving them outside the body at birth. Pregnant mothers probably will not notice any symptoms before their baby is born.

Gastroschisis is sometimes confused with a more serious birth defect called omphalocele. Unlike gastroschisis, omphalocele often involves several organs that are in a sac outside the belly. Children with omphalocele often also have other associated birth defects, while most children with gastroschisis do not.

Gastroschisis affects 1 to 2 in 10,000 children in the United States. Doctors don’t know what causes it.

Gastroschisis at Seattle Children’s

  • Gastroschisis treatment often starts in our Prenatal Diagnosis and Treatment Program. Our prenatal team helps families and their obstetricians get ready for the birth and plan for surgery to put the baby’s intestines back in their belly.

    Our staff includes neonatologists, surgeons and gastroenterologists who are experts in gastroschisis treatment. We usually see at least 20 babies with gastroschisis each year. Our surgery team has performed hundreds of surgeries to fix gastroschisis.

  • For many babies, our surgeons use a new technique to repair gastroschisis without using stitches and without putting newborns under general anesthesia.

    Our surgeons are specially trained in pediatric surgery, which means they understand children’s needs and how their bodies are different from adult bodies.

  • Learn what gastroschisis treatment is like from families whose babies were treated at Seattle Children’s.

Symptoms of Gastroschisis

If your baby has gastroschisis, you are not likely to notice any signs or symptoms related to the condition while you are pregnant.

After birth, your baby may have symptoms related to gastroschisis, especially if any organs were pinched, twisted or damaged when passing through the hole in your baby’s belly. Your doctor will look for these problems when your baby is born.

About 1 in 10 babies with gastroschisis has another bowel problem called intestinal atresia, which means part of their intestine has not formed completely and is blocked.

Diagnosing Gastroschisis

Doctors usually diagnose gastroschisis during a routine ultrasound before a baby is born. Routine blood tests for pregnant women may also show a high level of a protein called alpha-fetoprotein (AFP).

If your baby is diagnosed with gastroschisis, our Prenatal Diagnosis and Treatment Program can work with you and your doctor to plan your prenatal care and your baby’s treatment. If needed, our prenatal experts will talk with you about having genetic tests to check for other problems, although these are unlikely.

Treating Gastroschisis

All babies with gastroschisis need surgery shortly after birth to put their intestines back into their bellies. Because these babies need special care, it’s best for them to be born at a hospital that has a neonatal intensive care unit (NICU). Many parents choose to have their babies transferred to Seattle Children’s for surgery because of our specialized expertise with children and gastroschisis.

Babies can be moved to our Level IV NICU for surgery and care after surgery. Seattle Children’s was the first hospital in Washington to have a Level IV NICU.

  • Most of the time, babies with gastroschisis have surgery on the day they’re born. Sometimes, more than 1 procedure is needed to push the intestine back inside more gradually. The type of surgery needed will depend on your baby’s health and any bowel problems they have. Sometimes, the surgery can be done at the bedside and not require any stitches or even a general anesthetic. Sometimes, stitches and anesthesia are needed. Your surgeon will talk to you about the best treatment plan for your baby.

    After your baby is born

    After birth, we will move your baby from the delivery room to a stabilization room to assess their condition closely. We monitor breathing and administer an IV (intravenous) line — a tube that goes into a vein to give fluids. They will also need a tube in the nose or mouth that goes down to the stomach and empties it. Some babies need to be on a breathing machine (ventilator) to temporarily help their lungs.

    Sutureless technique

    While your baby waits for surgery, your doctor will put a plastic bag around their intestines to protect them and keep them warm. Most of the time, it takes only 1 surgery to fit the intestines back inside. Our surgery team can use a new technique called sutureless umbilical closure that repairs gastroschisis using the umbilical cord and may allow closure without general anesthesia or closing the hole with stitches. This may make it less likely your baby will get an infection or have other complications.

    Preventing damage to other organs

    In about 15% of infants with gastroschisis, there will not be enough room in the belly to put all the intestines back right away. In these cases, surgeons put the intestines in a bag that is attached to the baby’s belly. The intestines are squeezed back inside over 5 to 10 days. This lets the belly stretch and prevents damage to other organs.

  • It can take anywhere from 1 week to a few months for your baby’s intestines to start working. Your baby will likely need to be fed through a tube that goes into a large vein (central line) or a tube that passes through the nose or mouth into the stomach (nasogastric tube, NG tube; or orogastric tube, OG tube). We will give your baby medicine to reduce pain.

    How severe your baby’s gastroschisis is and how long they will stay in the hospital can vary. After surgeons place the intestine back into the belly, your baby will need to be in the hospital until they can eat well. The average length of stay in the hospital for gastroschisis is about a month and a half.

    As your baby’s health improves, we will move them from the NICU to a regular hospital room. This is usually a few days after the intestine is back in the belly and after we can remove the ventilator. At Seattle Children’s, babies with gastroschisis typically spend less time in the NICU than at other hospitals because our physicians, nurses and nutritionists have specialized expertise in helping children recover. This makes your family’s hospital stay less stressful and more comfortable.

    Some babies have trouble digesting food after the gastroschisis is fixed. With time, more than 95% of babies treated for gastroschisis will eat and gain weight normally. Our team of experts includes nutritionists who specialize in infants with problems such as this. These nutritionists will help monitor your baby to be sure they are growing and gaining enough weight.

    Whether you are breastfeeding or pumping, you can get lactation support from your nurses, Lactation Services and Occupational Therapy and Physical Therapy. They can help with questions or supplies.

    Children with gastroschisis usually don’t have long-term problems or need to keep coming back to the hospital. Our doctors and nurses are always here to help you and to answer questions.

Contact Us

To learn more about gastroschisis treatment at Seattle Children’s, call our General and Thoracic Surgery Department at 206-987-2794, ext. 4.