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Niger J Surg. 2019 Jul-Dec;25(2):163-166. doi: 10.4103/njs.NJS_11_19.

Outcome of Management of Neonatal Intestinal Obstruction at a Tertiary Center in Nigeria.

Author information

1
Department of Surgery, College of Medicine, University of Ibadan, Ibadan, Nigeria.
2
Department of Surgery, College of Health Sciences, Bowen University, Iwo, Nigeria.

Abstract

Background:

Intestinal obstruction in a newborn remains a significant emergency in pediatric surgery. Clinical presentation is often subtle with sudden deterioration of their clinical states. Clinical outcome in the developing countries is poor owing to a variety of factors.

Objective:

The objective of this study is to identify the factors affecting the management outcome in our environment.

Patients and Methods:

Data on clinical presentation, management, and outcome of all neonates managed for intestinal obstruction over a 13-year period at a tertiary center in Nigeria were retrospectively reviewed. Analysis of factors affecting the management outcome was also performed.

Results:

One hundred and seventeen neonates comprising 85 (72.7%) boys and 32 (27.3%) girls were managed for intestinal obstruction. The age at presentation ranged from 0 to 29 days, with a mean of 6.86 ± 8.4 days. Seventy-five (64.1%) patients presented within a week of onset of symptoms and 42 (35.9%) patients later. Eighty-five patients (72.6%) presented with symptoms from birth. The most common causes of intestinal obstruction included anorectal malformation in 62 (53%) neonates and Hirschsprung's disease in 16 (13.7%) neonates. Other causes included obstructed inguinoscrotal hernias, duodenal atresia, jejunoileal atresia, malrotation, and annular pancreas. Eleven patients died with a mortality rate of 9.4%. The age at presentation (P = 0.001) and the presence of postoperative complications (P = 0.009) were significantly related to the duration of hospital stay. Furthermore, the presence of postoperative complications (P = 0.012) was significantly associated with postoperative mortality.

Conclusion:

Early presentation and postoperative complications significantly affected the morbidity and mortality associated with the management of neonates with intestinal obstruction.

KEYWORDS:

Intestinal obstruction; morbidity; mortality; neonate

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