Patterns and Surgical Outcome of Pediatric Intestinal Obstruction in Pakistan

  • Ali Raza Chaudhry
  • Muhammad Umar Nisar
  • Anwar Khan
  • Nadeem Akhtar
  • Samer Sikander
  • Nisar Ahmed Khan

Abstract

Background: Intestinal obstruction in children is a very common cause of admission in hospitals with usually a high mortality andmorbidity 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 departmentPediatric 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 variableswere studied.Results: Total cases were 316 (231 males, 85 females). Congenital Causes of intestinal obstruction in descending order wereAnorectal Malformations(75),Jejuno-Ileal Atresia(28), Hirschsprung Disease(27), Meckel's Diverticulum(17), DuodenalAtresia(16), Malrotation(12), Meconium Ileus(11), Midgut Volvulus(8), Mesenteric cyst(1) and Rectal Atresia(1).Acquired causeswere Intussusception(40), Perforated Appendix(20), Infantile Hypertrophic Pyloric Stenosis(14), Band Obstruction(12), BluntAbdominal 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 wasfound between Age and post operative complications (P=0.048), Age and outcome (P=0.002) and between post operativecomplications and outcome (p<0.001).Conclusions: Causes of intestinal obstruction vary according to the age and geographical area. Accurate and timely diagnosis ofthe 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

Author Biographies

Ali Raza Chaudhry
Resident Paediatric Surgery, The Children's Hospital, PakistanInstitute of Medical Sciences, Islamabad, Pakistan.
Muhammad Umar Nisar
Resident Paediatric Surgery, The Children's Hospital, PakistanInstitute of Medical Sciences, Islamabad, Pakistan
Anwar Khan
Consultant Pediatrics Surgeon, Saidu Group of Teachinghospital, Swat, Pakistan
Nadeem Akhtar
Resident Paediatric Surgery, The Children's Hospital, PakistanInstitute of Medical Sciences, Islamabad, Pakistan.
Samer Sikander
Resident Paediatric Medicine, PAEC General Hospital Islamabad
Nisar Ahmed Khan
Associate Professor, Community Medicin, Mohiuddin IslamicMedical College, Mirpur, Azad Jammu & Kashmir
Published
2021-03-17