A Clinicopathological Study of Developmental and Acquired Causes of Intestinal Obstruction in Paediatric Population- A Retrospective Study

Abstract

Introduction: Intestinal Obstruction (IO) in the paediatric age group can be due to a variety of developmental and acquired causes which depend on the age at presentation. Histopathological examination of the resected intestine can provide definite evidence of underlying aetiology. Aim: To analyse the spectrum of lesions causing IO and it’s relation with clinicopathological features. Materials and Methods: This was a retrospective study conducted in the Department of Pathology at Seth G.S Medical College and Dr. R. N. Cooper Hospital, Mumbai, Maharashtra, India. Gross and microscopy of 70 surgically resected specimens of patients with IO, received over a period of five years, from January 2009 to December 2013, were studied after getting ethical clearance. Clinical details were retrieved from the records. Lesions were classified as developmental and acquired which were further categorised into infective, neoplastic and miscellaneous categories. Data was analysed using Microsoft excel 2010 and was expressed as frequency and percentage. Results: Out of the 70 cases studied there were 40 males and 30 females. There were 37 cases less than 1 month old, 13 cases between one month to 1 year age and 20 cases between 1 year to 12 years of age. The developmental category comprised of 52/70 cases (74.29%) with 17 cases of Meckel’s diverticulum,16 cases of intestinal atresia, three cases each of mesenteric cysts and duplication cysts, five cases of duodenal webs, four cases of congenital bands, one case each of lymphangiectatic cyst, malrotation, blind ileal loop and meconium ileus. In the acquired category there were three cases of tuberculosis and one case each of fungus and Ascaris infection. In the neoplastic category there were five cases of polyps and one case each of cystic teratoma and Burkitt lymphoma. There were three cases of volvulus, two of perforation and one case of intussusception. Conclusion: The present study highlights the various causes of IO in children from neonatal period up to 12 years of age. With proper gross and microscopic examination it was possible to give confirmed diagnosis which is necessary for further management of the patient.