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A newborn twin with an antenatal diagnosis of gastroschisis underwent staged repair of the abdominal wall defect. She developed multiple fistulae due to ischemic bowel and then abdominal wall dehiscence requiring additional surgical interventions. Obstructive jaundice, first evident at 3 weeks of age, became progressively severe. A stricture of the common bile duct was diagnosed by percutaneous transhepatic cholangiography. The stricture was treated by percutaneous biliary drainage, biliary stenting, and balloon dilation of the common bile duct. These procedures, commonly used in adults for biliary decompression, may be useful alternatives to surgical intervention in infants and children with obstructive jaundice due to bile duct stricture.

Three cases of gastroschisis are described, managed surgically in the neonatal period by staged reduction employing a dacron reinforced silastic sac. All three cases were treated during the postoperative period with the application of constant negative pressure around the thorax and abdomen. Reduction of the eviscerated mass appeared to be accelerated and all three cases survived. The possible benefits of constant negative pressure around the thorax and abdomen in the treatment of gastroschisis are discussed.