A Historical Review of Gastroschisis: Evolution of Understanding, Diagnosis, and Surgical Management

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Background/Objectives: Gastroschisis is a congenital abdominal wall defect characterized by herniation of bowel loops without a covering membrane and typically located to the right of the umbilical cord. Although contemporary management is well established, its historical study development has not been comprehensively synthesized. This review examines the chronological evolution of focus of interest in gastroschisis and highlights how research priorities shifted across eras, shaping current anatomical understanding, diagnostic strategies, and surgical management. Methods: A structured literature search was performed in PubMed, Web of Science, and Scopus. Studies in English, Spanish, Turkish, and Arabic were included. Titles, abstracts, and full texts were screened independently. Eligible publications addressed historical descriptions, differentiation from omphalocele, advancements in imaging, surgical techniques, or experimental modeling. Results: Sixty-eight studies met the inclusion criteria. Early reports from the sixteenth to eighteenth centuries provided descriptive accounts without distinguishing gastroschisis from omphalocele. The nineteenth century introduced the term “gastroschisis,” and definitive clinical differentiation was achieved in the mid twentieth century. Surgical innovation progressed from primary closure in the 1940s to the development of preformed and spring-loaded silos, which improved physiologic tolerance and survival. Animal models clarified mechanisms of bowel injury, including the effects of amniotic exposure and delayed maturation of interstitial cells of Cajal. Advances in ultrasound and magnetic resonance imaging facilitated prenatal risk stratification and shifted research attention toward predicting complex gastroschisis and optimizing perinatal planning. Conclusions: The historical trajectory of studies about gastroschisis demonstrates a coherent pattern in which developments in anatomical definition, surgical innovation, and mechanistic research sequentially enabled modern prenatal diagnostic and prognostic strategies. Recognizing these temporal shifts provides important context for current practice and highlights opportunities to improve prenatal markers of bowel compromise and refine individualized postnatal care.

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