Coexisting gastrointestinal and hepatobiliary tract anomalies in omphalocele and gastroschisis: A twenty-year experience in a single tertiary medical center

Chen-Chen Wen; Tien-Chueh Kuo; Hung-Chang Lee; Chun-Yan Yeung; Wai-Tao Chan; Chuen-Bin Jiang; Jin-Cherng Sheu; Nien-Lu Wang; Chyong-Hsin Hsu; Shu-Chao Weng; Yufeng Jane Tseng

doi:10.1016/j.pedneo.2022.03.009

Coexisting gastrointestinal and hepatobiliary tract anomalies in omphalocele and gastroschisis: A twenty-year experience in a single tertiary medical center

Pediatr Neonatol. 2022 Sep;63(5):468-473. doi: 10.1016/j.pedneo.2022.03.009. Epub 2022 May 18.

Authors

Affiliations

¹ Department of Pediatric Gastroenterology, Hepatology and Nutrition, MacKay Children's Hospital, Taipei, Taiwan; Department of Pediatrics, National Yang Ming Chiao Tung University Hospital, Yilan, Taiwan.
² The Metabolomics Core Laboratory, Centers of Genomic and Precision Medicine, National Taiwan University, Taipei, Taiwan.
³ Department of Pediatric Gastroenterology, Hepatology and Nutrition, MacKay Children's Hospital, Taipei, Taiwan.
⁴ Department of Pediatric Gastroenterology, Hepatology and Nutrition, MacKay Children's Hospital, Taipei, Taiwan; MacKay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan.
⁵ Department of Pediatric Gastroenterology, Hepatology and Nutrition, MacKay Children's Hospital, Taipei, Taiwan; Department of Medicine, Mackay Medical College, New Taipei City, Taiwan.
⁶ Department of Pediatric Surgery, Mackay Memorial Hospital, Taipei, Taiwan.
⁷ Department of Neonatology, MacKay Children's Hospital, Taipei, Taiwan.
⁸ Department of Pediatric Gastroenterology, Hepatology and Nutrition, MacKay Children's Hospital, Taipei, Taiwan. Electronic address: shuchao@gmail.com.
⁹ The Metabolomics Core Laboratory, Centers of Genomic and Precision Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan; Department of Computer Science and Information Engineering, National Taiwan University, Taipei, Taiwan. Electronic address: yjtseng@csie.ntu.edu.tw.

PMID: 35641386
DOI: 10.1016/j.pedneo.2022.03.009

Abstract

Background: Omphalocele and gastroschisis are the two most common congenital abdominal wall defects; however, no previous study has focused on gastrointestinal and hepatobiliary tract malformations in these two conditions. This study aimed to investigate the demographic characteristics, coexisting congenital gastrointestinal and hepatobiliary tract anomalies, hospital course, and outcomes of patients with gastroschisis and omphalocele.

Methods: This is retrospective chart review of all patients admitted to one tertiary medical center in Taiwan between January 1, 2000 and June 30, 2020 with a diagnosis of gastroschisis or omphalocele. The medical records were reviewed to obtain demographic data regarding coexisting gastrointestinal and hepatobiliary tract anomalies and outcomes.

Results: Of the 51 patients included, 21 had gastroschisis and 30 had omphalocele. Gastroschisis was associated with a significantly younger maternal age and a higher incidence of small for gestational age. Of the 30 patients with omphalocele, twelve had associated gastrointestinal and hepatobiliary anomalies. Seven of the 21 patients with gastroschisis had gastrointestinal anomalies, and none had hepatobiliary anomalies. Among the omphalocele patients, three (10%) had documented malrotation, and one developed midgut volvulus. Among gastroschisis patients, four patients (19%) had malrotation, and two developed midgut volvulus. There were no statistically significant differences in postoperative complications or mortality rates between those with and without gastrointestinal/hepatobiliary tract anomalies.

Conclusion: The diversity of coexisting gastrointestinal and hepatobiliary tract anomalies is higher in the omphalocele than in gastroschisis. In addition, we demonstrate that patients with gastroschisis or omphalocele have a higher rate of intestinal malrotation and midgut volvulus.

Keywords: Meckel diverticulum; digestivesystem abnormalities; intestinal volvulus; neonatology.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Gastroschisis* / complications
Gastroschisis* / diagnosis
Gastroschisis* / epidemiology
Hernia, Umbilical* / complications
Hernia, Umbilical* / diagnosis
Hernia, Umbilical* / epidemiology
Hospitals
Humans
Intestinal Volvulus* / surgery
Retrospective Studies