title: Gastroschisis and the risk of short bowel syndrome: outcomes and counselling.
abstract: BACKGROUND
  Gastroschisis can be associated with short bowel syndrome (SBS). We present 4 cases with significant bowel shortening with very different ante- and postnatal presentations.
  
  
  METHODS
  Three of the cases demonstrated 'vanishing' gastroschisis with progressively worsening antenatal intra-abdominal bowel dilatation with no defect present at birth. The fourth case followed an uneventful course antenatally but developed SBS considered secondary to gastroschisis-related atresia and necrosis. All 4 cases were classified as having SBS and were enrolled within the paediatric Intestinal Rehabilitation Programme. This involves autologous gastrointestinal reconstruction following a period of bowel expansion with concomitant parenteral and enteral nutrition.
  
  
  CONCLUSIONS
  These cases demonstrate that the serious complication of significant bowel loss cannot always be anticipated. Early multidisciplinary discussion with the parents enables a shared understanding of potential outcomes. It can aid the recognition of 'vanishing' gastroschisis enabling expedient investigations and early intervention, minimising morbidity and maximising bowel length.
authors.affiliation: Royal Manchester Children's Hospital, Manchester, UK.
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Wood
authors.forename: Rebekah A
authors.initials: RA
authors.lastname: Samangaya
authors.forename: Joanna C
authors.initials: JC
authors.lastname: Gillham
authors.forename: Antonino
authors.initials: A
authors.lastname: Morabito
mesh_terms: D013505:Digestive System Surgical Procedures; D037001:Directive Counseling; D004750:Enteral Nutrition; D005260:Female; D020139:Gastroschisis / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010288:Parenteral Nutrition; D011296:Prenatal Diagnosis; D012307:Risk Factors; D012778:Short Bowel Syndrome / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D015996:Survival Rate; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal