Comprehensive developmental mechanisms in gastroschisis.

INTRODUCTION

The development of gastroschisis remains an area of controversy. Various theories have been proposed, but none has ever been supported by a thorough embryological study.

MATERIAL AND

METHODS

We herein report anatomical and microscopic observations of the developing abdominal wall and cord of embryos and fetuses, along with clinical features of gastroschisis.

RESULTS

It appears that the developing cord normally has two parts, a firm left-sided part formed by the vessels and urachus, and a thin right-sided pouch covering the intestinal loops (the 'physiological umbilical hernia'), which could rupture, giving the basis of gastroschisis.

DISCUSSION: Gastroschisis could be the result of amniotic damage, possibly from some as yet unidentified toxin. Further bowel damage can be explained by the subsequent mesenteric injury.