Hand-made silo for the management of gastroschisis in a limited-resource setting: a case series

Introduction

Gastroschisis is a rare congenital abdominal wall defect whose management in resource-limited settings poses significant challenges of hypothermia, severe fluid loss resulting in shock, infections, intestinal necrosis, and intestinal obstruction. Commercially available preformed silo bags are often unaffordable and/or inaccessible.

Case presentations

We used self-made silo bags in four patients with gastroschisis. Case 1 was a 39-week male with a 4-cm defect, who achieved complete reduction of the eviscerated bowel by day of life 6, followed by successful abdominal closure. The silo became dislodged once during the reduction process, but it was replaced easily. His growth continues to be appropriate at six months of follow-up. Case 2 was a 40-week male with a 4 cm defect, who achieved full reduction of the eviscerated bowel by day of life 7. He continues to grow well at 2 months of follow up. Case 3 was a 38-week female with a large (9 cm) defect and extensive herniation, who had suffered hypothermia and fluid loss before arrival. the hand-made silo was placed without difficulties. Before the herniated bowel could be completely reduced, the family left against medical advice and the patient was lost to follow up. Case 4 was a 40-week male with a 5 cm defect. Like the previous patient, before the herniated bowel could be completely reduced, the family left against medical advice, and he was lost to follow up.

Conclusion

In resource-limited environments, self-made silo bags offer a practical and cost-effective solution for managing gastroschisis.