Presented by Sherif Emil, M.D., C.M.
Summary Slides: Gastroschisis Challenges North and South: Nigeria
Challenges
- Incidence varies across country
- BASELINE DATA (Zaria, 2000: 14 infants) Age presenting: 7hrs – 5days (median 24hrs)
- All delivered at home, unsupervised
- Primary fascial /skin only closure: 10
- Improvised (surgical silo): 3
- Limited NICU
- No TPN
- Mortality: 10 /14 (71%)
Key challenges have always centered around:
- Home delivery
- Delayed presentation
- Lack of appropriate silo material
- Anaesthesia challenges
- Lack of NICU facilities
- Limited parenteral nutrition infection
Measures Taken to Address Challenges
- Avoiding/minimising surgery as much as possible
- Using various types/modifications of preformed silo
- Kano silo
- Alexis retractor (expensive, recent cheaper version from China: $91 vs $12)
- Nutrition
- Partial parenteral nutrition (Trophamine, Freamine, Astymin)
- Early trophic enteral feeding
- Tailored enteral feeding schedule
THP Source: