1. Gastrointestinal Disease Diagrams & Xrays
Barbara McFadden RN, MSN, NNP-BC
Woman’s Hospital of Texas - Houston
9/21/2018

2. TEF: Classification
9/21/2018

3. TEF/EA Radiographic Diagnosis
9/21/2018

4. Malrotation with volvulous

5. Double bubble
9/21/2018

6. Abdominal Wall Defects
Gastroschisis
Oomphalocele
9/21/2018

7. *
07/16/96
Gastroschisis
Abdominal wall defect to right of umbilicus; no covering; generally intestines; not usually associated with anomalies
9/21/2018 *

8. Gastroschisis Compared to Omphalocele*
07/16/96
Gastroschisis Compared to Omphalocele
An omphalocele, on the other hand, is a midline defect involving the umbilical cord. The size can vary from small (smaller than a pecan) to extremely large with involvement of other midline structures (heart, bladder). The defect is covered, though the covering may be ruptured in utero or during the process of delivery. Omphaloceles are often related to other anomalies, so a thorough examination and workup should be conducted prior to its repair.
Omphalocele
Gastroschisis
9/21/2018 *

9. Gastroschisis Compared to Omphalocele*
07/16/96
Gastroschisis Compared to Omphalocele
Omphalocele
Gastroschisis
9/21/2018 *

10. Gastroschisis – staged repair, silo*
07/16/96
Gastroschisis – staged repair, silo
Circulation
may be compromised to defect
contain carefully, do not twist or compress;
may become issue after closure reduction, especially in lower half of body
Initially, our concern is with compromise of the circulation to the bowel itself. It is imperative that the bowel not be twisted or manipulated in a manner that cuts off the blood flow. When Kerlix or a bag is applied to the area, take care not to wrap it tightly.
Compromised circulation is more commonly a problem following closure of the defect, particularly if the defect was large and the abdominal cavity small. The increased abdominal pressure can lead to decreased circulation to the bowel and lower extremities, as well as compromised ventilation. For this reason, staged reductions are performed if the bowel cannot be placed in the abdomen and closed without causing excessive intra-abdominal pressure and tension on the incision.
Staged reduction of gastroschisis
9/21/2018 *

11. 9/21/2018