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Category: Volume 06 Issue 04 April 2018
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Title: A Clinicopathological Study of Neonatal Intestinal Obstruction Pattern, Management and Various Outcomes in Babies Admitted in Tertiary Care Centre

Authors: Dr Samir Gupta, Dr Himanshu Gehlot, Dr Achal Gupta

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i4.182

Abstract

Introduction

The neonatal period is defined as the first 28 days after birth[1] Neonatal intestinal obstruction is one of the most common newborn surgical emergencies.[2] Incidence of Neonatal intestinal obstruction is 1 in 1500 live birth.[3] Successful management of a newborn with bowel obstruction depends on timely diagnosis and prompt management.[4] Failure to recognize neonatal bowel obstruction can result in various complications such as aspiration pneumonitis, sepsis, mid-gut ischaemia or perforation and enterocolitis.[5]

The principal features of neonatal intestinal obstruction are bile-stained vomiting, failure to pass meconium and abdominal distension. Early vomiting, in the first 24 hours of life, indicates a high obstruction (duodenal or jejunal) while the later onset of vomiting indicates a lower obstruction (ileal or colonic).6 The degree of abdominal distension correlates roughly with the height of the intestinal obstruction.

The diagnosis and management of the patient with intestinal obstruction is one of the most challenging emergencies that a surgeon can come across. Although the mortality due to acute intestinal obstruction is decreasing with better understanding of pathophysiology, improvement in diagnostic techniques, fluid and electrolyte correction, much potent anti-microbials and surgical management, still mortality ranges from 3% for simple obstruction to as much as 30% when there is vascular compromise or perforation of the obstructed bowel. This is further influenced by the clinical setting and related co-morbidities. Early diagnosis of obstruction, skillful operative management, proper technique during surgery and intensive postoperative treatment yield gratifying results.

The aim of this study was to detect the patterns of neonatal intestinal obstruction and to find out the problems and outcome of surgical treatment in specialized neonatal surgical setup in our centre.

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Corresponding Author

Dr Himanshu Gehlot