Late onset small bowel obstruction post Gastroschisis

Abstract

Presentation
A 28-year-old male presented with a five-day history of gradually worsening abdominal pain associated with vomiting, constipation and abdominal distention, on a background of Gastroschisis as a newborn.

Diagnosis
CT abdomen pelvis demonstrated complex small bowel obstruction with two transition points in the proximal jejunum and ileum, with suspected intestinal malrotation.

Treatment
An emergency midline laparotomy was performed with extensive adhesiolysis, small bowel resection, and formation of a loop jejunostomy. Long-term at home total parenteral nutrition was initiated whilst awaiting stoma reversal. The loop jejunostomy was successfully reversed three months post-operatively.

Discussion
Gastroschisis predisposes to bowel obstruction with the majority happening within one year after repair. Improved survival rates have led to a need for longitudinal data on long-term prognosis and complications. This case report details a late presentation of complex small bowel obstruction post gastroschisis, its complications and management.