In a recent paper by Fawley et al, the authors looked at the risk of midgut volvulus in 414 patients with abdominal wall defects. The risk of midgut volvulus was 1% in patients with gastroschisis and 4.4% in patients with omphalocele.
This makes sense when once considers the fact that bowel in gastroschisis is much more inflamed and thus prone to adhesion formation, than bowel inside an omphalocele sac.
What do we do with this information. For me, I would start considering a Ladd's procedure in the setting of an omphalocele where the bowel is healthy enough to manipulate and the abdominal cavity allows for easy reduction at the time of repair
This makes sense when once considers the fact that bowel in gastroschisis is much more inflamed and thus prone to adhesion formation, than bowel inside an omphalocele sac.
What do we do with this information. For me, I would start considering a Ladd's procedure in the setting of an omphalocele where the bowel is healthy enough to manipulate and the abdominal cavity allows for easy reduction at the time of repair