Gastroschisis and exomphalos

Abstract

The earliest description(s) of exomphalos date from antiquity though credit is linked with the French surgeon Ambrose Pare for providing the first accurate account of the malformation and its grave prognosis in the sixteenth century. Exomphalos was considered universally fatal until success with surgical treatment was published in the early 1800s. Scarpa (1814) later emphasized a spectrum of malformation severity. In 1899 Ahfield introduced the concept of conservative management by applying alcohol dressings to the exposed sac. This method was modified by Grob some 60 years later with the introduction of mercurochrome. Creation of a 'skin silo' by mobilising abdominal wall skin to cover the intact sac in large exomphalos lesions was advocated by Olshausen (1877), Williams (1930) and later Robert Gross at Children's Hospital Boston in 1948.