Operative outcome of neonates with intestinal obstruction: a one year prospective study from January 2020 to December 2020 at Tikur anbessa specialized hospital Addis Ababa, Ethiopia.
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Date
2021-12
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Addis Abeba University
Abstract
Background
Neonatal intestinal obstruction (NIO) is one of the most common emergency conditions a
pediatric surgeon is called upon to assess during the neonatal period. Successful management of
NIO depends on timely diagnosis and referral for therapy. In developing countries, like Ethiopia,
many challenges are encountered in managing these neonates and the outcomes remain poor.
Despite TASH having been offering treatment for neonates with intestinal obstruction for many
years, the pattern and outcomes (morbidity and mortality) of these patients remain unknown.
This necessitates local research on this disease not only as an audit of our care but also to
generate more information on this complex disease process.
The purpose/aim of this study was to review the pattern of intestinal obstruction in the neonatal
period, its associated complications and outcome of management in order to determine factors
associated with death of these newborns in TASH, Addis Ababa , Ethiopia.
Methodology
A Prospective describtive single-center study of neonates who were operated for intestinal
obstruction at TASH were studied. Factors that determine post-operative outcome and associated
morbidity and mortalities were analyzed in all patients.
Results: During the twelve months period, One thousand four hundred sixty babies were
admitted at the pediatric ward and NICU. Eighty two (5.6%) of these were cases of neonatal
intestinal obstruction. There were 59 males and 23 females, with male to female ratio of 2.5:1.
The mean weight of the neonates was 2.7kg (range 1.5-4.0kg). The average age at operation was
6.8 days (1-34days), the mean duration of symptoms before presentation was 4.2 days. The
major indication for operation was Anorectal malformation53 patients {64.6%}, Hirschsprung’s
disease11 {11.5%}, Intestinal atresia 15 patients {18.3%) }, malrotation 3 patients (3.6%). The
overall mortality recorded in this study due to intestinal obstruction was 20.7% (17 patients).
Severe sepsis with multi organ failure was ascribed for the death of 10(58.8%) of neonates.
Conclusion: The morbidity and mortality of neonatal intestinal obstruction in this hospital is due
to the problems of late presentation and sepsis at presentation. The findings are at variance with
those in developed countries
Description
Keywords
Neonates ,Intestinal obstruction