Gastroschisis is herniation of bowel through a paraumbilical, usually right, ventral wall defect. There is no sac, and the exposure of the bowel serosa to amniotic fluid causes a serositis, with gelatinous exudate surrounding leathery loops of adhesed bowel (right image). It is more common with young mothers and prematurity (40%), and there is rarely any associated anomaly except atresia (10-15%). The incidence of gastroschisis is 1/3 that of omphalocele. The etiology is unclear, with theories proposing a defect at the site of the right umbilical vein or omphalomesenteric artery involution, teratogens such as drugs or X-rays, and vasoactive substances such as nicotine, pseudoephedrine and cocaine. The incidence of gastroschisis appears to be increasing.
Prune belly syndrome, also called triad syndrome and Eagle-Barrett syndrome, is characterized by widespread abdominal muscle aplasia, and results from failure of the ventral muscle plate to migrate, fuse, and differentiate normally. The skin of the abdominal wall is thin, lax and wrinkled, and there are invariably associated urinary tract anomalies (bladder hypertrophy, hydroureter/hydronephrosis, and cryptorchidism). It is unclear whether primary urethral obstruction is the initiating factor.
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