Education for the GS Bowel Injury Score

The Gastroschisis (GS) bowel injury severity score is a composite scoring tool applied to the bowel of GS patients at birth and at each attempted abdominal closure. 

The scored variables include: 
    1) Bowel matting: None, mild or severe 
    2) Bowel necrosis: Absent, focal or diffuse
    3) Bowel atresia: Absent, suspected or present
    4) Bowel perforation: Absent or present

Below, please see a text description and photographic examples of "bowel matting". Clicking on an image will display a larger version.

No Matting

Bowel is essentially normal: pliable, soft, not thickened; minimal fibrin formation on surface. No intestinal or mesenteric foreshortening. 

Mild Matting

Serosal surface is dull (i.e. not shiny); moderate fibrin "peel", mostly non-adherent. Some thickening with loss of pliability in both bowel wall and mesentery. Bowel loops adherent to each other but separable. Some intestinal foreshortening may be present.

Severe Matting

Marked bowel wall thickening, non-pliability. Bowel loops "congealed" with one another. May be difficult to trace individual loops. Abundant fibrin which is quite adherent. Variable bowel discoloration (white/purplish red). Marked intestinal and mesenteric foreshortening.