Paediatric surgery: gastroschisis initial care: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Paediatric surgery: gastroschisis initial care

Sample item

A newborn has loops of thickened bowel outside the abdomen through a defect to the right of the umbilical cord, with no covering membrane. What is the best immediate management?

ACover the bowel with warm saline gauze and plastic wrap, gastric decompression, IV fluidsBDry gauze dressing and oral feedingCImmediate reduction of bowel by manual pressureDDelay all measures until surgery in 48 hours

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Cover the bowel with warm saline gauze and plastic wrap, gastric decompression, IV fluids

Gastroschisis is a paraumbilical abdominal wall defect with no sac, associated with young maternal age and few other anomalies. The exposed bowel loses heat and fluid, so it is wrapped in warm saline-soaked gauze and clear plastic or placed in a bowel bag, with nasogastric decompression, IV fluids and antibiotics. Closure is primary or staged using a silo.

Option by option

A. Cover the bowel with warm saline gauze and plastic wrap, gastric decompression, IV fluids (correct)
Correct. Preventing heat and fluid loss and decompressing the gut stabilise the infant.
B. Dry gauze dressing and oral feeding
Dry dressing adheres and worsens losses, and a baby with bowel exposed must not feed orally.
C. Immediate reduction of bowel by manual pressure
Forced manual reduction causes compromise of mesenteric blood flow and respiratory embarrassment.
D. Delay all measures until surgery in 48 hours
Delay without protection leads to hypothermia, dehydration and sepsis.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is A, Cover the bowel with warm saline gauze and plastic wrap, gastric decompression, IV fluids. Gastroschisis is a paraumbilical abdominal wall defect with no sac, associated with young maternal age and few other anomalies.

Why is "Dry gauze dressing and oral feeding" not the answer?

Dry dressing adheres and worsens losses, and a baby with bowel exposed must not feed orally.

Why is "Immediate reduction of bowel by manual pressure" not the answer?

Forced manual reduction causes compromise of mesenteric blood flow and respiratory embarrassment.

Why is "Delay all measures until surgery in 48 hours" not the answer?

Delay without protection leads to hypothermia, dehydration and sepsis.

What concept does this question test?

It tests Paediatric surgery: gastroschisis initial care in General Surgery. The exposed bowel loses heat and fluid, so it is wrapped in warm saline-soaked gauze and clear plastic or placed in a bowel bag, with nasogastric decompression, IV fluids and antibiotics. Closure is primary or staged using a silo.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Paediatric surgery: gastroschisis initial care?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.