Abstract
The purpose of our study was to evaluate the morbidity-morality of rare neonatal digestive emergencies in order to improve their management. Observations: 7 newborns ranging in age from 6 hours to 3 weeks were treated for rare digestive pathologies between January 2013 and July 2017 (a period of 3 years and 6 months) in the Department of Pediatric surgery of Brazzaville University Center, Congo. Males were predominant (5 versus 2 females). Pathologies listed were: 1 antenatal volvulus of the small intestine, 1 annular pancreas and 5 gastric perforations. The average time of care in the operating room was 12 hours. The newborns were hospitalized in the pediatric surgery department in 28.6% of cases (n = 2), and 71.4% (n = 5) in the neonatology department. The antenatal volvulus of the intestine and annulus pancreas were integrated into a nosologic entity named neonatal occlusion (NNO). The postoperative outcomes were simple for 4 patients (57.14%) while 3 patients died immediately after surgery (42.86%). Conclusion: Neonatal surgical emergencies are still difficult to manage in our context. The lack of knowledge of these rare pathologies, which delays their management, considerably increases morbidity-mortality. The critical analysis of this series highlights diagnostic and therapeutic difficulties particularly with gastric perforations, hence the interest of better popularization of pediatric surgery.
Highlights
Neonatal digestive surgical emergencies are congenital or acquired conditions of the newborn’s digestive tube that require immediate surgical intervention [1] [2]
Observations: 7 newborns ranging in age from 6 hours to 3 weeks were treated for rare digestive pathologies between January 2013 and July 2017 in the Department of Pediatric surgery of Brazzaville University Center, Congo
The antenatal volvulus of the intestine and annulus pancreas were integrated into a nosologic entity named neonatal occlusion (NNO)
Summary
Neonatal digestive surgical emergencies are congenital or acquired conditions of the newborn’s digestive tube that require immediate surgical intervention [1] [2]. Digestive pathologies represent more than half of neonatal surgical emergencies [2] With their average frequency estimated at 1/5000 live births and their mortality rate still high according to the literature, they constitute a serious perinatal health problem [1] [3]. The classical manifestation is sub-occlusive array requiring nursing, the forms of intestinal still found indicate the establishment of a bypass colostomy [3]. Some of these pathologies are classified as rare because of their low frequency [5] [6], but they are a real management problem in the context of underdeveloped countries. The purpose of our study is to evaluate the morbidity-mortality of these rare neonatal digestive emergencies in order to improve their management
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