Staged closure with negative pressure wound therapy for gastroschisis with liver herniation: A case report


      Liver herniation with gastroschisis is an uncommon occurrence that is associated with a poor prognosis. This report presents a single case of complex gastroschisis complicated by herniation of the left hepatic lobe. In the subject case, the abdominal wall defect was successfully closed by sequential closure with negative pressure wound therapy after the initial application of a preformed silo. As there are no established standards for the management of gastroschisis with liver herniation, there exists an opportunity for multicenter review to define approaches to optimize clinical outcomes with this complex congenital issue. As a result of the complexity and rarity of this congenital abnormality, reports with a positive prognosis carry clinical relevance.

      Key words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Pediatric Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Alvarez S.M.
        • Burd R.S.
        Increasing prevalence of gastroschisis repairs in the United States: 1996–2003.
        J Pediatr Surg. 2007; 42: 943-946
        • Holland A.J.
        • Walker K.
        • Badawi N.
        Gastroschisis: an update.
        Pediatr Surg Int. 2010; 26: 871-878
        • McClellan E.B.
        • Shew S.B.
        • Lee S.S.
        • et al.
        Liver herniation in gastroschisis: incidence and prognosis.
        J Pediatr Surg. 2011; 46: 2115-2118
        • Kassa A.M.
        • Lilja H.E.
        Predictors of postnatal outcome in neonates with gastroschisis.
        J Pediatr Surg. 2011; 46: 2108-2114
        • Skarsgard E.D.
        • Claydon J.
        • Bouchard S.
        • et al.
        Canadian Pediatric Surgical Network: a population-based pediatric surgery network and database for analyzing surgical birth defects. The first 100 cases of gastroschisis.
        J Pediatr Surg. 2008; 43: 30-34
        • Molik K.A.
        • Gingalewski C.A.
        • West K.W.
        • et al.
        Gastroschisis: a plea for risk categorization.
        J Pediatr Surg. 2001; 36: 51-55
        • Arnold M.A.
        • Chang D.C.
        • Nabaweesi R.
        • et al.
        Risk stratification of 4344 patients with gastroschisis into simple and complex categories.
        J Pediatr Surg. 2007; 42: 1520-1525
        • Arnold M.A.
        • Chang D.C.
        • Nabaweesi R.
        • et al.
        Development and validation of a risk stratification index to predict death in gastroschisis.
        J Pediatr Surg. 2007; 42: 950-956
        • Emil S.
        • Canvasser N.
        • Chen T.
        • et al.
        Contemporary 2-year outcomes of complex gastroschisis.
        J Pediatr Surg. 2012; 47: 1521-1528
        • Choi W.W.
        • McBride C.A.
        • Kimble R.M.
        Negative pressure wound therapy in the management of neonates with complex gastroschisis.
        Pediatr Surg Int. 2011; 27: 907-911