Umbilical hernia repair post umbilical cord graft closure of gastroschisis: A cohort study

Int J Surg Case Rep. 2022 Jun:95:107175. doi: 10.1016/j.ijscr.2022.107175. Epub 2022 May 11.

Abstract

Introduction: Gastroschisis a common congenital anomaly in the anterior abdominal wall, the bowel is present outside the abdominal cavity, completely devoid of any coverings, management of gastroschisis involves umbilical cord graft coverage of the defect after bowel reduction when there are concerns about compartmental syndrome, this is a widely used technique but there are few reports about the incidence umbilical hernia development after this technique and need for future repair of the defect.

Presentation of cases: We had 8 patients with simple gastroschisis who had umbilical cord graft coverage of the defect at birth between 2017 and 2020, we present 4 patients who had the cord graft without cutting of rectus fascia, 2 patients resolved spontaneously and 2 developed an umbilical hernia requiring repair.

Discussion: Umbilical cord graft has been reported in several studies, in those studies the authors reported the spontaneous closure of the defect and some reported that incising the rectus fascia will contribute to development of the umbilical hernia, in our series the rectus fascia was preserved yet 2 patients developed umbilical hernia.

Conclusion: Pediatric surgeons should look out for umbilical hernia in patients who had umbilical cord graft repair of gastroschisis defect and closure should be carried out by an experienced surgeon.

Keywords: Gastroschisis; Umbilical cord graft; Umbilical hernia.