Seven-week embryo with gastroschisis, multiple anomalies, and physiologic hernia suggests early onset of gastroschisis

Gastroschisis is an increasingly common birth defect involving the development of the ventral body wall. Extrusion of the bowel is usually paraumbilical, usually right sided, and associated anomalies are less common than in omphalocele. Recently, hypotheses regarding the timing of the typical gastroschisis defect have come into question. Unlike previous theories, Feldkamp et al. (2007) has postulated that gastroschisis occurs much earlier in development, before abdominal wall closure, which is completed by about 35 days postconception. We present a case of a spontaneously aborted dysmorphic embryo which exhibits features of the normal physiologic herniation of the midgut as well as gastrochisis. The co-existence of the abdominal wall defect in this abnormal embryo with the physiologic hernia supports the early development of this defect and also illustrates the causal heterogeneity of gastroschisis.