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G65 Long-term Gastro-intestinal morbidities in children with abdominal wall defects
  1. RE Jackson1,
  2. DH Parikh1,
  3. A Plunkett1,
  4. J Turner2
  1. 1Paediatric Surgery, The Birmingham Childrens Hospital, Birmingham, UK
  2. 2School of Health and Related Research, University of Sheffield, Sheffield, UK

Abstract

Introduction Outcome studies following repair of Congenital Abdominal Wall defect has mainly focused on the first two years of life. It is recognised that children with complicated Gastroschisis, short gut and infants with gut failures requiring long term parenteral nutrition have prolonged gastro-intestinal morbidities.

Aims To indentify the prevalence of the GI morbidities in older children with congenital abdominal wall defects both Gastroschisis (G) and Exomphalos (E), who were uncomplicated and did not require prolonged gastrointestinal nutritional support. To describe the quality of life in this cohort, using a validated paediatric quality of life tool.

Patients and methods Cohort of children aged 2 to 16 years were identified from our database at Birmingham Children’s Hospital, that were either discharged from follow up or were followed up infrequently and had undergone repair of Gastroschisis or Exomphalos. We also recruited children that met our recruitment criteria from an online support forum Gastrobaby and Avery’s Angels. We sent a questionnaire to their parents to identify Gastro-oesophageal reflux disease; Vomiting; Failure to thrive; Chronic constipation; Faecal and urinary incontinence.

Results We received 58 responses (G 45, E 13) from 202 sent out questionnaires. These were analysed to identify a high prevalence gastro-intestinal sequels: Vomiting 3 times or more per week in 22% (G 9 E 4); Chronic constipation 26% (G14 E 1); Faecal incontinence 29% (G 15 E 2); Urinary incontinence 22% (G 10 E 3); Under 10th percentile for weight – 26% (G 10 E 5); Under 10th percentile for height – 32.7% (G 13 E 6). Birthweight under 10th percentile 25.8% (G 12 E 3).

We also used the PEDsQL for gastrointestinal symptoms (developed by Varni et al, 2006), to measure quality of life in this cohort. We found 35% of respondents scored under 600 score indicating that their quality of life was adversely affected by the presence of gastrointestinal symptoms.

Conclusion In this small cohort but in a well defined subgroup of both Gastroschisis and Exomphalos children, this study identifies high prevalence of morbidities amongst older children following repair of congenital abdominal wall defect and poor quality of life scores. Our study implicates the need for further clinical studies to define precisely the GI morbidities.

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