Abstract
BackgroundIntestinal atresia is a common cause of neonatal intestinal obstruction, and management of this disease in limited setup of a developing country is very difficult.MethodsThis study is a retrospective study of patients with jejunoileal atresias and their postoperative outcome in a teaching hospital in eastern Nepal over a 5-year period.ResultsThere were 28 children (19 boys and 9 girls). 11 children (39.28%) had jejunal atresia and 17 (60.71%) had ileal atresia. Eight (28.5%) patients died, 6 were jejunal atresia (54.5%) and 2 were ileal atresia (11.7%). The most common cause of death was sepsis which occurred in 7 out of 8 cases (87.5%). The risk factors for mortality identified were leucopenia, neutropenia, delay in surgery, location of atresia and type of atresia. Jejunal atresia tended to have a higher mortality than ileal atresia, and severe types of atresia (type IIIb and IV) were more often associated with mortality than other types of atresia. The significant differences between jejunal and ileal atresia were the increased duration between presentation and surgery, longer postoperative and total hospital stay, presence of more severe atresias and an increased risk of mortality in case of jejunal atresias.ConclusionThe prognosis for this disease have definitely changed in the last few decades in developed countries but in our environment, problems like late presentation and diagnosis, lack of availability of good neonatal intensive care units and parenteral nutritional support still prevail.
Highlights
Intestinal atresia is a common cause of neonatal intestinal obstruction
From January 2004 to December 2008, 28 children with jejunoileal atresia were operatively managed at the Department of Surgery, B
Minimal resection of the proximal bowel with antimesenteric tapering enteroplasty and end-to-end anastomosis with 4-0 vicryl had been for all jejunal atresias and proximal ileal atresias
Summary
Intestinal atresia is a common cause of neonatal intestinal obstruction, and management of this disease in limited setup of a developing country is very difficult. Intestinal atresia is a common cause of neonatal intestinal obstruction. The management of neonates with jejunoileal atresias has improved because of improvements neonatal intensive care, advances in operative techniques and use of total parenteral nutrition (TPN)[1,2,3]. With these approaches, the morbidity and mortality of these patients has decreased to a large extent. This study is a retrospective study to analyze clinical characteristics in patients with jejunoileal atresias and their postoperative outcome in a teaching hospital in eastern Nepal over a 5-year period
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