[size=20px]A baby girl is born with gastroschisis and transferred to a children’s hospital. A decision must be made between primary closure or placing a spring loaded silo as the initial intervention. What is the most common complication of a temporary spring silo placement for gastroschisis?

 

A prolonged time to full feeds

 

B sepsis

 

C prolonged hospital stay

 

D ventral hernia

 

E silo displacement​[/size]

E

All are possible complications

but I think the most common E displacement

A

C

A

E

C

E

C

A

E

E

Correct answer

E silo displacement

The most reported complication of silo placement is dislodgement. Replacement of the silo at the bedside is reportedly successful 80 to 90% of the time. With the advent of the spring loaded silo, primary closure rates have decreased. Sutureless closure as a primary procedure at the bedside, or initial silo closure with subsequent bedside sutureless closure are increasingly used techniques. Prior retrospective studies have shown no difference in length of stay or time to feeding when using a silo compared to primary closure. There have been reports of the need to increase the fascial opening to accommodate silo placement and the potential difficulty that results at closure. In addition, ischemia to the bowel has been reported if a silo bag is too tight or bowel is caught beneath the ring

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