Title: Etiological Spectrum of Neonates Presenting With Intestinal Obstruction at A Tertiary Care Centre
Authors: Dr Amit Nagpure, Dr Sneha Wardhane, Dr Sharan Gubbi, Dr Shrikesh Singh, Dr Arun Gupta, Dr Pradeep Gupta
DOI: http://dx.doi.org/10.18535/jmscr/v4i5.29
Introduction: Intestinal atresia is one of the most common cause of intestinal obstruction in neonates; with very few reported data from the developing countries. Objective: To describe the epidemiological distribution of neonatal intestinal obstruction (NIO) presenting at a tertiary care centre. Methods: Neonates admitted to our surgical NICU with a pre-operative diagnosis of NIO during a period from 1staugust 2013 to 31stDecember 2015 presenting within 14 days of life were considered. All cases of NIO associated with trachea- esophageal atresia, hirschsprung disease and anorectal malformations were excluded. An analysis of their post operative diagnosis was done. Results: A total of 271 neonates were included in our study. There were a total of 178 males and 93 females in our study. They presented at a mean age of 4.3 days and on an average weighed 1.9 kg. duodenal atresia was the most common cause of NIO (n= 82), followed by ileal atresia (n= 72). Other causes of NIO included jejuna ileal atresia, jejunal atresia, malrotation, colonic atresia, annular pancreas, duodenal webs, meconium ileus and band obstruction. Conclusion: Duodenal atresia is the most common cause of NIO followed by ileal atresia in our study 1. Stollman TH, de Blaauw I, Wijnen MH, et al. Decreased mortality but increased morbidity in neonates with jejunoileal atresia; a study of 114 cases over a 34-year period. J Pediatr Surg 2009; 44:217–21. 2. Texas Department of State Health Services. Birth defect risk factor series: atresia-stenosis of the small intestine. http://www.dshs.state.tx. Us/birth defects/risk/risk23-int_atr.shtm. Accessed January 12, 2012. 3. Cragan JD, Martin ML, Moore CA, et al. Descriptive epidemiology of small intestinal atresia, Atlanta, Georgia. Teratology 1993; 48:441– 50. 4. Forrester MB, Merz RD. Population-based study of small intestinal atresia and stenosis, Hawaii, 1986–2000. Public Health 2004; 118: 434–8. 5. Martı´nez-Frı´as ML, Castilla EE, Bermejo E, et al. Isolated small intestinal atresias in Latin America and Spain: epidemiological analysis. Am J Med Genet 2000; 93:355–9. 6. Anjali Verma, K N Rattan, R Yadav. Neonatal intestinal obstruction: a 15 year experience in a tertiary care hospital: journal of clinical and diagnostic research. 2016 Feb, Vol- 10(2): SC10- SC13. 7. Rowe, et al. Essentials of paediatric surgery. Mosby year book, Inc. (1995). 8. Spitz L. Neonatal intestinal obstruction and intussusception in children, In: Schwartz SI and Ellis H (editors) Maingots abdominal operations, 8th edition, vol.2, New York: Appleton-Century-Croft, 1985; 1054-62. 9. Kimura K. Bilious vomiting in the newborn: rapid diagnosis of intestinal obstruction. Am Fam Physician. 2000; 61(9):2791-98. 10. Yevgeniya N, Mary R, Clarivet T. long term outcomes for infants with intestinal atresia studied at children’s national medical centre: journal of paediatric gastroenterology and nutrition. 2013 sep, Vol 57(3): 324- 329 11. Seth A, Chanchlani R, Rakhonde AK. Neonatal gastrointestinal emergencies in a tertiary care centre in Bhopal, India: A prospective study. IJSS Journal of Surgery. 2015; 1(5):1-4. 12. Annigeri VM, Mahajan JK, Rao KL. Aetiological spectrum of acute intestinal obstruction. Indian Paediatr. 2009; 46(12):1102-03. 13. Banu T. Pattern of intestinal obstruction in Bangladeshi children, MS Thesis, 1992, University of Dhaka, 45-87. 14. Islam MR. Intestinal obstruction in neonates- pattern, aetiology and management, MS thesis, 1996, University of Dhaka, 56-64. 15. Hanif A, Hasina K, Islam MK, Matin MA, Talukder SA. Neonatal intestinal obstruction: six years experience in DMCH, Bangladesh, BJMS. 2009; 15(1):42- 45. 16. AK Saha, MB Ali, SK Biswas et al. neonatal intestinal obstruction: patterns, problems and outcome. Bang Med J (Khulna) 2012; 45 : 6-10 17. Islam SS, Jafor A, Faisal I, Ahmed M. Aetiology and treatment out come of neonatal intestinal obstruction in a tertiary hospital. J Ped Sur Bang. 2010; 1(1):30- 36. 18. Narang M, Kausik JS, Sharma AK et al. predictors of mortality among the neonates transported to referral centre in Delhi, India: Indian J public health 2013; 57 : 100-4Abstract
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