Incidence and Short term Outcome of Management of Neonatal Intestial Obstructin (NIO)
Iranian Journal of Pediatric Surgery,
Vol. 3 No. 1 (2017),
3 October 2017
Neonatal intestinal obstruction (NIO) is a challenging and common emergency situation in pediatric surgery. In order to successfully manage it one should make a timely diagnosis and apply standard treatment.Management of neonatal intestinal obstructions have improved in many developed countries, but still show high morbidity and mortality in developing countries. This study was done to evaluate the incidence and short term outcome of neonatal intestinal obstruction at the department of pediatric surgery, Zagazig university hospitals in Egypt.
Material and Methods:
This retrospective study included 84 patients whom presented with intestinal obstruction during their first month of life to the emergency departments of Zagazig university hospitals in Egypt from Jan 2008 to Jan 2011and were managed surgically.
Of these 84 patients 50 were males and 34 were female. The mean age at presentation was 3.5 (2-10) days for duodenal atresia, 2.5 (3-5) days for jejunoileal atresia , 2 (1-10) days for meconium ileus with perforation, 2 (1-5) days for patients with volvulus, 7 (5-20) days for colonic atresia, 20 (10-30) days for Hirschsprung disease, 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. Death occurred in 10 patients (12%). In 3 patients with jejunoileal atresia anastomotic leakage occurred; they underwent re-operation but died. In 3 patients with duodenal atresia death occurred postoperatively from sepsis and DIC. Two patients with high anorectal malformations died 2 days post operative from associated cardiac anomalies and 2 patients with colonic atresia died post operatively from sepsis and electrolyte imbalance.
The most common cause of intestinal obstruction in neonates in our study 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 in our center.
- Intestinal obstruction
Adeyemi D: Nonatal intestinal obstruction in developing tropical country: patterns, problems and prognosis. J Trop Pediatr 1989; 35:66.
De sliva NT,Young AJA,Wales PW: Understanding neonatal bowel obstruction: building knowledge to advance practice. Neonatal Netw 2006; 25:303-18.
Mhando S, Young B, 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-Behbahan A, Jamshidi M,Veisi P,Zarrintan S: intestinal malrotations: a review and report of thirty cases. Folia Morphol (Warrsz) 2007; 66: 277-82.
Ladd WE: surgical diseases of the alimentary tract in infants. N Engl J Med 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 jejuna atresia. 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; 10:238-44.
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 Med J 2007; 28:1050-4.
Ezomike UO, Ekenze SO, Amah CC: Outcome of surgical management of intestinal atresia. Nigerian Journal of clinical practice 2014; 17:479-483.
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;17:685-711.
Wax JR, Hamilton T, Cartin A, Dudley J, Pinette MG, Blackstone J: Congenital jejunoileal atresia: J Ultrasound Med 2006; 25:337-42.
Ekenze SO, Ibeziako SN, Ezomike UO. Trends in neonatal intestinal obstruction in a developing country1996-2005.World J Surg 2007;31:2405-9.
Lima M, Ruggeri G, Domini M, Gargano T, Mazzero G, et al: Evaluation of the surgical management of bowel atresia in newborn: Laparoscopic assisted treatment. Pediatric Med Chir 2009;31:215-9.
Pheps S, Fisher R, Partington A, Dykes E. Prenatal ultrasound diagnosis of gastrointestinal malformations. J Pediatr Surg 1997; 32:438-40.
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.
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