Neonatal Intestinal Obstruction in Aba Nigeria

Abstract

Background: Intestinal obstruction in the neonate is a common indication for neonatal emergency surgery. Failure to pass meconium by a full-term neonate within the first 24 hours of life should raise a suspicion of bowel obstruction. The objective of this study was to determine pattern of presentation, diagnosis and outcome of management of intestinal obstruction in the neonates at the Abia State University Teaching Hospital Aba. Methodology: A Prospective study of fifty-four neonates who presented with clinical and radiological findings consistent with intestinal obstruction that was treated at Paediatric Surgical unit, Department of Surgery, of the Abia State University Teaching Hospital Aba between October 2016 to 0ctober 2018. Proforma was opened for sex, weight, age at presentation, clinical presentation, duration of symptoms prior to presentation, surgical pathology, treatment offered, complications and management outcome Results: During the twenty-five months period, Eight hundred babies were admitted at the special care baby unit of the hospital. Fifty-four babies (6.75%) of these were cases of neonatal intestinal obstruction. There were 40 males and 14 females, with male to female ratio of 4:1. The mean weight of the neonates was 2.5kg (range 1.1-4.3kg). The average age at operation was 3 days (1-15days), the mean duration of symptoms before presentation was 3.5days. The major indication for operation was Anorectal malformation 32 patients {59.3%}, Hirschsprung’s disease10 {18.5%}, Intestinal atresia 8 patients {14.8%}, obstructed hernia 4 patients {7.4%}. Conclusion: The morbidity and mortality of neonatal intestinal obstruction in this hospital is due to the problems of late presentation and poor neonatal intensive care facilities. The findings are at variance with those in developed countries.