Patterns and Surgical Outcome of Pediatric Intestinal Obstruction in Pakistan
DOI:
https://doi.org/10.52206/jsmc.2021.11.1.39-44Abstract
Background: Intestinal obstruction in children is a very common cause of admission in hospitals with usually a high mortality and
morbidity rate. There is a geographical variability in patterns of intestinal obstruction in pediatric population around the globe.
Objectives: To evaluate patterns of presentation and surgical outcome of pediatric intestinal obstruction in Pakistan.
Material and Methods: A prospective observational study with non-probability sampling technique was done in the department
Pediatric Surgery (East Surgical Unit), The Children's Hospital, Pakistan Institute of Medical Sciences (PIMS), Islamabad,
Pakistan, from January to December 2017. Operated cases of intestinal obstruction from 1 day to 12 years were included. Age,
patterns of presentation, sign and symptoms, surgical intervention, complications, outcome and correlation between variables
were studied.
Results: Total cases were 316 (231 males, 85 females). Congenital Causes of intestinal obstruction in descending order were
Anorectal Malformations(75),Jejuno-Ileal Atresia(28), Hirschsprung Disease(27), Meckel's Diverticulum(17), Duodenal
Atresia(16), Malrotation(12), Meconium Ileus(11), Midgut Volvulus(8), Mesenteric cyst(1) and Rectal Atresia(1).Acquired causes
were Intussusception(40), Perforated Appendix(20), Infantile Hypertrophic Pyloric Stenosis(14), Band Obstruction(12), Blunt
Abdominal Trauma(10), Obstructed Inguinal hernia (9), Worm infestation(9), Enteric Perforation(3), Necrotizing Enterocolitis(3).
The overall mortality rate was 3.5% and postoperative complications rate was 40.8%. Statistically significant relationship was
found between Age and post operative complications (P=0.048), Age and outcome (P=0.002) and between post operative
complications and outcome (p<0.001).
Conclusions: Causes of intestinal obstruction vary according to the age and geographical area. Accurate and timely diagnosis of
the cause of intestinal obstruction along with prevention and treatment of sepsis can reduce morbidity and mortality.
Key words: Intestinal obstruction; Children; Congenital; Acquired Causes; Neonate; Pakistan
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