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INCIDENCE AND SHORT-TERM RESULTS OF TREATMENT OF NEONATAL INTESTINAL OBSTRUCTION

Dr Rohan Habib, Dr Muhammad Waqas Afzal, Dr Hassaan ul Hassan Tahir Ghazi

Neonatal intestinal obstruction (NIO) is a common and difficult emergency in paediatric surgery. To successfully cope, it is needed to make a quick diagnosis and standard treatment. Management of neonatal intestinal obstruction has improved in many developed countries, but still shows high morbidity and mortality in developing countries. Aim: This study was conducted to assess the incidence and short-term effects of neonatal intestinal obstruction. Place and Duration: In the Department of Paediatric Surgery, Ayub Teaching Hospital Abbottabad for two year duration from March 2017 to March 2019. Methods: This retrospective study involved 84 patients who surgically treated intestinal obstruction during the first month in the emergency department at the Children's Hospital Lahore. Results: Of these 84 patients, 50 are males and 34 females. The average age at the time of presentation was 3.5 (2-10) days for duodenal atresia, 2.5 (3-5) days for jejunoileal atresia, 2 (1-10) days meconium ileus with perforation, volvulus seen in 2 (1-5) days, 7 (5-20) days for colonic atresia, 20 (10-30) days for Hirschsprung disease, 25 (5-30) days for patients with congenital inguinal hernia and 2 (1-4) rectum developmental defects. After resuscitation, all patients underwent surgery. Death occurred in 10 patients (12%). Three patients with atresia of the jejunum had leakage of the anastomosis, underwent a new surgery, but died. Three patients with duodenal atresia died after surgery due to sepsis and DIC. Two patients with major anorectal defects died two days after surgery due to associated cardiac abnormalities, and two patients with sepsis and electrolyte imbalance died after surgery. Conclusion: Anorectal anomalies and congenital inguinal hernia are the most common causes of intestinal obstruction in neonates. Mortality and morbidity remain high compared to statistics from developed countries due to the late presentation and due to improper setting. Keywords: Intestinal obstruction, neonatal, results.

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