Report of three cases of unusual anterior abdominal wall defects in Fallujah General Hospital

“….The third case was associated with ambiguous genitalia, spine, pelvic & lower limb abnormalities in addition to the abnormally large abdominal wall defect. All three case were very unusual, a combination that has not been previously reported in the literature….”

“..The first two babies died shortly after birth….”

“….The third was stillborn….”

Report of three cases of unusual anterior abdominal wall defects in Fallujah General Hospital during the year 2010

Samira Alaani, MB.Ch.B, D.Ch
Fallujah General Hospital, Althubbadh, Fallujah, Iraq

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Abstract

DOI: http://dx.doi.org/10.5915/44-1-10354

“…Abdominal wall defects occur when the normal sequence of the gastro intestinal tract development is interrupted. Gastroschisis represents a herniation of abdominal contents through a paramedian full-thickness abdominal wall fusion defect without involving the umbilical cord. Evisceration usually only contains intestinal loops and has no surrounding membrane unlike omphalocoele. It is unusual for a newborn with gastroschisis to have other serious birth defects. Neonates with gastroschisis have better prognosis than those with omphalocele. Very rarely is gastroschisis associated with herniation of other organs, and their presence makes the prognosis worse.

I report three cases of unusual anterior abdominal wall defects during the year 2010, each having specific associated abnormalities. One was stillborn, and the other two died shortly after delivery….”

“…In Fallujah, prenatal ultrasonography is done routinely but not adequately. There are many cases of fetal anomalies that are missed because the equipment quality is poor and the sonographers’ training is relatively inadequate. In addition, MSFAP is not done routinely.
Karyotyping is not available. Autopsy is generally only performed in medicolegal or police cases, and no autopsy was requested or performed for these three cases. These factors made the diagnosis of these defects difficult.

During the year 2010, 3 cases of unusual abdominal wall defects were reported in Fallujah General Hospital out of 7,314 total births. The incidence was about 4/10,000 births compared to the overall incidence of 0.4-3/10,000 births for gastroschisis and 1.5-3/10.000 live births for omphalocele.

“..The first two babies died shortly after birth….”

The third was stillborn. Detailed history from the 3 cases revealed that there were no risk factors and no exposure to known teratogens. The first case was associated with rib cage abnormality in addition to herniation of the small and large bowel. The second case was associated with herniation of liver in addition to the intestine. The third case was associated with ambiguous genitalia, spine, pelvic & lower limb abnormalities in addition to the abnormally large abdominal wall defect. All three case were very unusual, a combination that has not been previously reported in the literature….”

Keywords

Gastroschisis; Fallujah; Iraq; Abdominal wall thickness defect

Full Text: PDF

http://jima.imana.org/article/view/10354

May 2, 2013 - Posted by arclight2011 | Uncategorized

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