Incidence and Short term Outcome of Management of Neonatal Intestial Obstructin (NIO)

Mohamed El sayed Eraki--- Department of Pediatric Surgery, Faculty of Medicine, Zagazig University, Egypt,
Atef Abd hamid Ekiabi--- Department of Pediatric Surgery, Faculty of Medicine, Zagazig University, Egypt

Abstract


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Abstract:

Background:

Neonatal intestinal obstruction NIO is one of the most common emergency conditions a pediatric surgeon is called to assess during neonatal period, Successful management of NIO depends on timely diagnosis and referrals for therapy (1).Neonatal intestinal obstructions have improved in many developed countries, but still show high morbidity and mortality in developing countries(2) .

Objectives:

This study was done to evaluate the incidence and short term outcome of neonatal intestinal obstruction at department of pediatric surgery, Zagazig university hospitals.

Patients and methods:

This retrospective study had done at department of pediatric surgery, Zagazig university hospitals, Egypt; include 84 patients presented by intestinal obstruction during  the first month of life from Jan 2008 to Jan 2011and was managed surgically.

Results:

There were 84 patients presented by intestinal obstruction during the first month of life,50 males and 34 females; in  which  10 patients(11.9%) with  duodenal atresia, and 7 patients( 8.3%)with jejunoileal atresia, and 5 patients(5.9%) with meconium ileus with perforation, and 5 patient (5.9%) with volvulus ,and 5patients(5.9%)with colonic atresia ,and 15patients (17.8%)with Hirschsprung disease, and 17patients(20.2%)with obstructed congenital inguinal hernia, and 20 patients(23.8%) with anorectal malformations. The mean age at presentation to surgeon was 3.5(2-10) days for duodenal atresia,and2.5(3-5) days for jejunoileal  atresia ,and 2 (1-10)days for meconium ileus with perforation, and 2(1-5)days for patients with volvulus ,and 7(5-20) days for colonic atresia , and 20(10-30) days for Hirschsprung disease, and 25(5-30) days for patients with obstructed congenital inguinal hernia, and 2(1-4)days for anorectal malformations. Surgery was done for all patients after resuscitation. The morality was happed in 10 patients (12%), in which 3 patients with jejunoileal atresia was developed leakage from anastomosis and re-operated and died, and 3 patients with duodenal atresia was died postoperative from sepsis and DIC, and 2 patients with high anorectal malformations was died 2 days post operative from associated cardiac anomalies, and 2 patients with colonic atresia was died post operative from sepsis and electrolyte imbalance.

Conclusion:

From our study the most common cause of neonatal intestinal obstruction was anorectal malformations and obstructed congenital inguinal hernia. Mortality and morbidity is still high compared with statistics from developed countries due to late presentation to pediatric surgeon and there is no specific neonatal surgical intensive care unit beside the pediatric surgery department.

Abstract:

Background:

Neonatal intestinal obstruction NIO is one of the most common emergency conditions a pediatric surgeon is called to assess during neonatal period, Successful management of NIO depends on timely diagnosis and referrals for therapy (1).Neonatal intestinal obstructions have improved in many developed countries, but still show high morbidity and mortality in developing countries(2) .

Objectives:

This study was done to evaluate the incidence and short term outcome of neonatal intestinal obstruction at department of pediatric surgery, Zagazig university hospitals.

Patients and methods:

This retrospective study had done at department of pediatric surgery, Zagazig university hospitals, Egypt; include 84 patients presented by intestinal obstruction during  the first month of life from Jan 2008 to Jan 2011and was managed surgically.

Results:

There were 84 patients presented by intestinal obstruction during the first month of life,50 males and 34 females; in  which  10 patients(11.9%) with  duodenal atresia, and 7 patients( 8.3%)with jejunoileal atresia, and 5 patients(5.9%) with meconium ileus with perforation, and 5 patient (5.9%) with volvulus ,and 5patients(5.9%)with colonic atresia ,and 15patients (17.8%)with Hirschsprung disease, and 17patients(20.2%)with obstructed congenital inguinal hernia, and 20 patients(23.8%) with anorectal malformations. The mean age at presentation to surgeon was 3.5(2-10) days for duodenal atresia,and2.5(3-5) days for jejunoileal  atresia ,and 2 (1-10)days for meconium ileus with perforation, and 2(1-5)days for patients with volvulus ,and 7(5-20) days for colonic atresia , and 20(10-30) days for Hirschsprung disease, and 25(5-30) days for patients with obstructed congenital inguinal hernia, and 2(1-4)days for anorectal malformations. Surgery was done for all patients after resuscitation. The morality was happed in 10 patients (12%), in which 3 patients with jejunoileal atresia was developed leakage from anastomosis and re-operated and died, and 3 patients with duodenal atresia was died postoperative from sepsis and DIC, and 2 patients with high anorectal malformations was died 2 days post operative from associated cardiac anomalies, and 2 patients with colonic atresia was died post operative from sepsis and electrolyte imbalance.

Conclusion:

From our study the most common cause of neonatal intestinal obstruction was anorectal malformations and obstructed congenital inguinal hernia. Mortality and morbidity is still high compared with statistics from developed countries due to late presentation to pediatric surgeon and there is no specific neonatal surgical intensive care unit beside the pediatric surgery department.

Abstract:

Background:

Neonatal intestinal obstruction NIO is one of the most common emergency conditions a pediatric surgeon is called to assess during neonatal period, Successful management of NIO depends on timely diagnosis and referrals for therapy (1).Neonatal intestinal obstructions have improved in many developed countries, but still show high morbidity and mortality in developing countries(2) .

Objectives:

This study was done to evaluate the incidence and short term outcome of neonatal intestinal obstruction at department of pediatric surgery, Zagazig university hospitals.

Patients and methods:

This retrospective study had done at department of pediatric surgery, Zagazig university hospitals, Egypt; include 84 patients presented by intestinal obstruction during  the first month of life from Jan 2008 to Jan 2011and was managed surgically.

Results:

There were 84 patients presented by intestinal obstruction during the first month of life,50 males and 34 females; in  which  10 patients(11.9%) with  duodenal atresia, and 7 patients( 8.3%)with jejunoileal atresia, and 5 patients(5.9%) with meconium ileus with perforation, and 5 patient (5.9%) with volvulus ,and 5patients(5.9%)with colonic atresia ,and 15patients (17.8%)with Hirschsprung disease, and 17patients(20.2%)with obstructed congenital inguinal hernia, and 20 patients(23.8%) with anorectal malformations. The mean age at presentation to surgeon was 3.5(2-10) days for duodenal atresia,and2.5(3-5) days for jejunoileal  atresia ,and 2 (1-10)days for meconium ileus with perforation, and 2(1-5)days for patients with volvulus ,and 7(5-20) days for colonic atresia , and 20(10-30) days for Hirschsprung disease, and 25(5-30) days for patients with obstructed congenital inguinal hernia, and 2(1-4)days for anorectal malformations. Surgery was done for all patients after resuscitation. The morality was happed in 10 patients (12%), in which 3 patients with jejunoileal atresia was developed leakage from anastomosis and re-operated and died, and 3 patients with duodenal atresia was died postoperative from sepsis and DIC, and 2 patients with high anorectal malformations was died 2 days post operative from associated cardiac anomalies, and 2 patients with colonic atresia was died post operative from sepsis and electrolyte imbalance.

Conclusion:

From our study the most common cause of neonatal intestinal obstruction was anorectal malformations and obstructed congenital inguinal hernia. Mortality and morbidity is still high compared with statistics from developed countries due to late presentation to pediatric surgeon and there is no specific neonatal surgical intensive care unit beside the pediatric surgery department.v


Keywords


Intestinal obstruction, Neonates, Outcomes.

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References


References:

- Adeyemi D,Nonatal intestinal obstruction in developing tropical country .pattern,problem and prognosis.J Trop Pediatr.1989;35(2):66.

-De La Hunt MN. The acute abdomen in newborn .Semin Fetal Neonatal Med.2006 jun.11 (3):191-7

-De sliva NT,Young AJA,Wales PW.Understanding neonatal bowel obstruction: building knowledge to advance practice. Neonatal Netw.2006 sep-oct.25 (5):303-18.

-MhandoS, YoungB, Lakhoo K.The scope of emergency pediatric surgery in Tanzania.Pediatr Surg Int 2008; 24(2);2410-2411.

-Pitcher G.Trends in neonatal intestinal obstruction in developing country .World J Surg 2007; 31(12):2410-2411.

-Aslanabadi S, Ghalehgolab-BehbahanA, Jamshidi M,Veisi P,Zarrintan S. intestinal malrotations: a review and report to thirty cases.Folia Morphol(Warrsz).2007 Nov.66(4):277-82.

-Ladd WE.surgical diseases of the alimentary tract in infants.N Engl JMed.1936;705;215.

-Pena A,Anorectal malformations:Experience with the posterior sagittal approach.In :Stringer MD,Oldham KT,Howard ER,eds,1998,376-386.

-Banieghbal B,Beale PG.Minimal access approach to jejunalatresia.J Pediatric Surg 2007;42(8):1362-1364.

-Chen QJ,Gao ZG,Tou JF,et al. congenital duodenal obstruction in neonates: a decade’s experience from one center.World j Pediatr.2014 Aug.10(3):238-44.

-Raffensperger JG.Pyloric and duodenal obstruction. In Raffensperger JG ed Swenson’s pediatric surgery,5th Edition.Norwalk:Appleton&Lange 1990;509-516.

-Louw JH,Barnaed CN.Congential intestinal atresia: observations on its origin.Lancet.1955;2:1065:

- Santulli TV, Banc WA, Congenital atresia of the intestine: pathogenesis and treatment .Ann Sur 1961; 154:939.

-Ozturk H,Gedik S,Duran H,Onen A.A comprehensive analysis of 51 neonates with congenital intestinal atresia. Saudi MedJ 2007; 28:1050-4.

-Ezomike UO,Ekenze.SO,Amah.CC:Outcome of surgical management of intestinal atresia. Nigerian Journal of clinical practice .Jul-Aug 2014.Vol 17.issue 4.479-483.

-Burjonrappa S,Crete E,Bouchard S.Comparative outcomes in intestinal atresia:A clinical outcome and pathophysiology analysis .Pediatric Surg Int 2011;27:10-35.

- Juang D,Snyder CL,Neonatal bowel obstruction .surg clin North America.2012,April 17.92:685-711.(Medline full text).

- Wax JR,Hamilton T,Cartin A,Dudley J,Pinette MG,Blackstone J.Congenital jejuna ans ileal atresia:J Ultrasound Med 2006;25:337-42.

-Ekenze SO,Ibeziako SN,Ezomike UO.Trends in neonatal intestinal obstruction in a developing country,1996-2005.World J Surg 2007;31:2405-9.

-Lima M,Ruggeri G,Domini M,Gargano T,Mazzero G,Landuzzi V,et al. Evaluation of the surgical management of bowel atresia in newborn : Laparoscopic assisted treatment .Pediatric Med Chir.2009 sep-oct.31(5):215-9.[Medline].

-Pheps S,Fisher R,Partington A,Dykes E.Prenatal ultrasound diagnosis of gastrointestinal malformations .J Pediatr Surg.1997 Mar.32(3):438-40.[Medline].

-Kaddah SN,Bahaa-AldinKHK,Aly HF,Hassan HS.Congenital duodenal obstruction. Annals pediatr surg.2006; 2:130-5.

-Dalla Vecchia LK,Grosfeld JL,West KW et al. Intestinal atresia and stenosis :

A 25- year experience with 277 cases. Arch Surg 1998;133:490-497.




DOI: http://dx.doi.org/10.22037/irjps.v3i1.14757

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