Introduction and objective: Correction of gastroschisis may be accomplished by either primary or staged closure or even delayed primary closure after the use of a preformed silo. However, there is neither a consensus on the best approach nor established criteria to favor one method over the other. The aim of this paper was to investigate the role of intravesical pressure (IVP) as a tool to prevent abdominal compartment syndrome in newborns undergoing correction of abdominal wall defects. Methods: We retrospectively analyzed 45 newborns with gastroschisis in whom trans-operative intravesical pressure was used to choose between primary or staged closure. A threshold of 20 cm H2O was used and the outcomes between the two methods were compared. Results: In 24 children delayed primary closure was achieved while the remaining 21 underwent staged reduction and closure. There was no difference in the frequency of complications, time to begin oral feeding, length of parenteral nutrition or length of hospital stay between the children of the two groups. The incidence of temporary oliguria or anuria, averaged 33% and it was similar in both groups of children. Conclusion: The data here presented suggests that monitoring intraoperative IVP during correction of gastroschisis may help to select children in whom staged closure is necessary, keeping their complication rate and overall outcome similar to that of children undergoing delayed primary closure. Further prospective studies should investigate more deeply the correlation between type of closure and the development of a compartment syndrome. © 2012 Informa UK, Ltd.25814381441Canty, T.G., Collins, D.L., Primary fascial closure in infants with gastroschisis and omphalocele: A superior approach (1983) Journal of Pediatric Surgery, 18 (6), pp. 707-712Sauter, E.R., Falterman, K.W., Arensman, R.M., Is primary repair of gastroschisis and omphalocele always the best operation? (1991) Am Surg, 57, pp. 142-144Fischer, J.D., Chun, K., Moores, D.C., Andrews, H.G., Gastroschisis: A simple technique for staged silo closure (1995) J Pediatr Surg, 30, pp. 1169-1171Fonkalsrud, E.W., Smith, M.D., Shaw, K.S., Borick, J.M., Shaw, A., Selective management of gastroschisis according to the degree of visceroabdominal disproportion (1993) Annals of Surgery, 218 (6), pp. 742-747Swartz, K.R., Harrison, M.W., Campbell, J.R., Campbell, T.J., Long-term follow-up of patients with gastroschisis (1986) American Journal of Surgery, 151 (5), pp. 546-549. , DOI 10.1016/0002-9610(86)90540-4Allotey, J., Davenport, M., Njere, I., Charlesworth, P., Greenough, A., Ade-Ajayi, N., Patel, S., Benefit of preformed silos in the management of gastroschisis (2007) Pediatric Surgery International, 23 (11), pp. 1065-1069. , DOI 10.1007/s00383-007-2004-9Nakayama, M., Horikawa, D., Nagai, H., Tamiya, K., Fujita, S., Namiki, A., Utility of intra-bladder pressure monitoring during closure of abdominal wall defects in newborn infants (1992) Masui, 41, pp. 1647-1650Banieghbal, B., Gouws, M., Davies, M.R., Respiratory pressure monitoring as an indirect method of intra-abdominal pressure measurement in gastroschisis closure (2006) Eur J Pediatr Surg, 16, pp. 79-83McGuigan, R.M., Mullenix, P.S., Vegunta, R., Pearl, R.H., Sawin, R., Azarow, K.S., Splanchnic perfusion pressure: A better predictor of safe primary closure than intraabdominal pressure in neonatal gastroschisis (2006) J Pediatr Surg, 41, pp. 901-904Marven, S., Owen, A., Contemporary postnatal surgical management strategies for congenital abdominal wall defects (2008) Semin Pediatr Surg, 17, pp. 222-235Schmidt, A.F., Gonçalves, A., Bustorff-Silva, J.M., Oliveira Filho, A.G., Marba, S.T., Sbragia, L., Does staged closure have a worse prognosis in gastroschisis? (2011) Clinics, 66, pp. 563-566. , Sao PauloBustorff-Silva, J.M., Schmidt, A.F., Gonçalves, A., Marba, S., Sbragia, L., The female condom as a temporary silo: A simple and inexpensive tool in the initial management of the newborn with gastroschisis (2008) J Matern Fetal Neonatal Med, 21, pp. 648-651Miranda, M.E., Tatsuo, E.S., Guimaraes, J.T., Paixao, R.M., Lanna, J.C.B.D., Use of a plastic hemoderivative bag in the treatment of gastroschisis (1999) Pediatric Surgery International, 15 (5-6), pp. 442-444. , DOI 10.1007/s003830050629Di, T.G.L., Rosano, A., Mastroiacovo, P., Prevalence of gastroschisis at birth: Retrospective study (2002) British Medical Journal, 325 (7377), pp. 1389-1390Laughon, M., Meyer, R., Bose, C., Wall, A., Otero, E., Heerens, A., Clark, R., Rising birth prevalence of gastroschisis (2003) Journal of Perinatology, 23 (4), pp. 291-293. , DOI 10.1038/sj.jp.7210896Baerg, J., Kaban, G., Tonita, J., Pahwa, P., Reid, D., Gastroschisis: A sixteenyear review (2003) J Pediatr Surg, 38, pp. 771-774Vilela, P.C., Ramos, D.A., Falbo, G.H., Santos, L.C., Risk factors for adverse outcome of newborns with gastroschisis in a Brazilian hospital (2001) Journal of Pediatric Surgery, 36 (4), pp. 559-564. , DOI 10.1053/jpsu.2001.22282Sydorak, R.M., Nijagal, A., Sbragia, L., Hirose, S., Tsao, K., Phibbs, R.H., Schmitt, S.K., Albanese, C.T., Gastroschisis: Small hole, big cost (2002) Journal of Pediatric Surgery, 37 (12), pp. 1669-1672. , DOI 10.1053/jpsu.2002.36689Driver, C.P., Bowen, J., Doig, C.M., Bianchi, A., Dickson, A.P., Bruce, J., The influence of delay in closure of the abdominal wall on outcome in gastroschisis (2001) Pediatric Surgery International, 17 (1), pp. 32-34. , DOI 10.1007/s003830000441Driver, C.P., Bruce, J., Bianchi, A., Doig, C.M., Dickson, A.P., Bowen, J., The contemporary outcome of gastroschisis (2000) J Pediatr Surg, 35, pp. 1719-1723Schlatter, M., Norris, K., Uitvlugt, N., DeCou, J., Connors, R., Improved outcomes in the treatment of gastroschisis using a preformed silo and delayed repair approach (2003) J Pediatr Surg, 38, pp. 459-464. , discussion 459Lao, O.B., Larison, C., Garrison, M.M., Waldhausen, J.H., Goldin, A.B., Outcomes in neonates with gastroschisis in U.S. children's hospitals (2010) Am J Perinatol, 27, pp. 97-101Lacey, S.R., Bruce, J., Brooks, S.P., Griswald, J., Ferguson, W., Allen, J.E., Jewett Jr., T.C., Cooney, D.R., The relative merits of various methods of indirect measurement of intraabdominal pressure as a guide to closure of abdominal wall defects (1987) Journal of Pediatric Surgery, 22 (12), pp. 1207-1211Lacey, S.R., Carris, L.A., Beyer III, A.J., Azizkhan, R.G., Bladder pressure monitoring significantly enhances care of infants with abdominal wall defects: A prospective clinical study (1993) J Pediatr Surg, 28, pp. 1370-1374. , discussion 1374Chin, T., Wei, C., Prediction of outcome in omphalocele and gastroschisis by intraoperative measurement of intravesical pressure (1994) J Formos Med Assoc, 93, pp. 691-693Olesevich, M., Alexander, F., Khan, M., Cotman, K., Gastroschisis revisited: Role of intraoperative measurement of abdominal pressure (2005) Journal of Pediatric Surgery, 40 (5), pp. 789-792. , DOI 10.1016/j.jpedsurg.2005.01.043, PII S0022346805000813Rizzo, A., Davis, P.C., Hamm, C.R., Powell, R.W., Intraoperative vesical pressure measurements as a guide in the closure of abdominal wall defects (1996) American Surgeon, 62 (3), pp. 192-196Sekabira, J., Hadley, G.P., Gastroschisis: A third world perspective (2009) Pediatr Surg Int, 25, pp. 327-329Van Eijck, F.C., Wijnen, R.M.H., Van Goor, H., The incidence and morbidity of adhesions after treatment of neonates with gastroschisis and omphalocele: A 30-year review (2008) Journal of Pediatric Surgery, 43 (3), pp. 479-483. , DOI 10.1016/j.jpedsurg.2007.10.027, PII S0022346807008251