Intestinal Perforation (Gastroschisis)

1-day-old girl in whom three loops of intestine lie outside the abdominal wall; they are dilated to different degrees and cover the umbilical cord which lies on the abdominal wall. In the lower part of the intestinal loops which lie on the left side some crumbly masses of only minimally stained meconium are visible. Due to an intrauterine or perinatal ischemia of the intestinal wall (for instance due to incarceration at the abdominal cleft) an intestinal perforation has occurred into the peritoneal and amniotic cavity with a resulting meconium peritonitis. This necrotic intestinal segment must be considered during surgery of the presented case of typical gastroschisis. Notice as additional findings the edema and hematoma of the vulva which are possibly the sequels of a breech presentation. The external genitals seem to be male (for comparison, see chapter 'striking and abnormal external genitals').