Incidence and Short term Outcome of Management of Neonatal Intestial Obstructin (NIO)

Neonatal intestinal obstruction NIO is one of the most common emergency conditions a pediatric surgeon is called to assess during neonatal period, Successful management of NIO depends on timely diagnosis and referrals for therapy (1).Neonatal intestinal obstructions have improved in many developed countries, but still show high morbidity and mortality in developing countries(2) .
This study was done to evaluate the incidence and short term outcome of neonatal intestinal obstruction at department of pediatric surgery, Zagazig university hospitals.
Patients and This retrospective study had done at department of pediatric surgery, Zagazig university hospitals, Egypt; include 84 patients presented by intestinal obstruction during the first month of life from Jan 2008 to Jan 2011and was managed surgically.
There were 84 patients presented by intestinal obstruction during the first month of life,50 males and 34 females; in which 10 patients(11.9%) with duodenal atresia, and 7 patients( 8.3%)with jejunoileal atresia, and 5 patients(5.9%) with meconium ileus with perforation, and 5 patient (5.9%) with volvulus ,and 5patients(5.9%)with colonic atresia ,and 15patients (17.8%)with Hirschsprung disease, and 17patients(20.2%)with obstructed congenital inguinal hernia, and 20 patients(23.8%) with anorectal malformations. The mean age at presentation to surgeon was 3.5(2-10) days for duodenal atresia,and2.5(3-5) days for jejunoileal atresia ,and 2 (1-10)days for meconium ileus with perforation, and 2(1-5)days for patients with volvulus ,and 7(5-20) days for colonic atresia , and 20(10-30) days for Hirschsprung disease, and 25(5-30) days for patients with obstructed congenital inguinal hernia, and 2(1-4)days for anorectal malformations. Surgery was done for all patients after resuscitation. The morality was happed in 10 patients (12%), in which 3 patients with jejunoileal atresia was developed leakage from anastomosis and re-operated and died, and 3 patients with duodenal atresia was died postoperative from sepsis and DIC, and 2 patients with high anorectal malformations was died 2 days post operative from associated cardiac anomalies, and 2 patients with colonic atresia was died post operative from sepsis and electrolyte imbalance.
From our study the most common cause of neonatal intestinal obstruction was anorectal malformations and obstructed congenital inguinal hernia. Mortality and morbidity is still high compared with statistics from developed countries due to late presentation to pediatric surgeon and there is no specific neonatal surgical intensive care unit beside the pediatric surgery department.v