Neonatal Intestinal Obstruction: A 5 Year Experience in a Tertiary Hospital in Enugu, Nigeria

Abstract

Background: Neonatal intestinal obstruction is one of the most common surgical emergencies in a newborn requiring the services of a pediatric surgeon. This study reports the etiology, sex incidence, age of presentation, management and outcome of neonatal intestinal obstruction in pediatric surgical unit of a tertiary hospital in Enugu, Nigeria. Methodology: This was a retrospective study of neonates who presented, at Enugu State University Teaching Hospital, with intestinal obstruction over a 5-year period. Result: Thirty five neonates were recruited into the study. There were 24 (68.6%) males and 11 (31.4%) females. Five patients (14.3%) were delivered before term (preterm) while thirty patients (85.7%) were delivered at term. Most of the patients (54.3%) presented after 72 hours from onset of symptoms. Abdominal distension was the most common symptomatology recorded in our patients. Necrotizing enterocolitis was the most common etiology in our patients accounting for 17 neonates (48.6%). This was followed by anorectal malformation 5 (14.3%), obstructed hernia 4 (11.4%), intestinal atresia 4 (11.4%), Hirschsprung’s disease 3 (8.6%), meconium plug 2 (5.7%). Colostomy formation was the most common surgical procedure performed. Twenty percent of our patients developed post-operative complication and mortality was 22.9%. Conclusion: Necrotizing enterocolitis is the most common cause of neonatal intestinal obstruction in the current study. With the mortality of 22.9%, the outcome in our patients is still poor and requires some improvements.