scholarly journals Intestinal Atresia: Experience at a Busy Center of North-West India

2016 ◽  
Vol 5 (4) ◽  
pp. 51 ◽  
Author(s):  
Shilpi Gupta ◽  
Rahul Gupta ◽  
Soumyodhriti Ghosh ◽  
Arun Kumar Gupta ◽  
Arvind Shukla ◽  
...  
Keyword(s):  
Anastomotic Leak ◽  
Primary Anastomosis ◽  
Demographic Data ◽  
Intestinal Atresia ◽  
Late Presentation ◽  
Duodenal Atresia ◽  
North West ◽  
Colonic Atresia ◽  
Duodenal Web ◽  
Time Of Presentation

Objective: To evaluate the presentation, management, complications and outcome of intestinal atresia (IA) managed at our center over a period of 1 year.Materials and methods: Records of patients of IA admitted in our center from January 2015 to December 2015 were retrospectively analyzed. Demographic data, antenatal history, presenting complaints, location (duodenal, jejunoileal, colonic) of atresia, surgery performed and peri-operative complications were noted.Results: Total 78 cases of IA were included in the analyses. Mean age and weight at the time of presentation was 5.8 days (range 0-50), and 1.9 kg (range 1.1-3.2), respectively. IA included duodenal atresia [DA (32)], jejuno-ileal atresia [JIA (40)], colonic atresia [CA (3)] and atresia at multiple-location (sites) in 3 cases. Ninety percent of patients underwent surgery within 5 to 20 hours of admission. All cases of DA except one underwent Kimura’s diamond shaped duodeno-duodenostomy. One case with perforated duodenal web underwent duodenotomy with excision of web. Seven patients with JIA and CA required primary stoma, while rest were managed by excision of dilated proximal segment and primary anastomosis. Complications included anastomotic leak in 5, proximal perforation in 2, functional obstruction in 7, aspiration pneumonitis in 3, and wound infection in 6 patients. Mean hospital stay for survivors was 11 days. Overall survival was 63%.Conclusion: Late presentation, overcrowding in intensive care unit, septicemia, functional obstruction and anastomotic leak are the causes of poor outcome in our series. Early diagnosis, some modification in surgical technique, use of total parenteral nutrition and adequate investigations for other congenital anomalies may improve the outcome.

scholarly journals Congenital Neonatal Intestinal Obstruction: Retrospective Analysis at Tertiary Care Hospital

2016 ◽  
Vol 5 (4) ◽  
pp. 49 ◽  
Author(s):  
Vijay Singh ◽  
Manish Pathak
Keyword(s):  
Intestinal Obstruction ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
Intestinal Atresia ◽  
Duodenal Atresia ◽  
Care Hospital ◽  
Abdominal Radiography ◽  
Colonic Atresia ◽  
Neonatal Intestinal Obstruction ◽  
Overall Mortality

Background: The purpose of this study is to analyze the etiology, clinical presentation and outcome of neonatal intestinal obstruction at our institute.Materials and Methods: The medical record of all the patients, presented with intestinal obstruction in neonatal period during 2014 and 2015 was reviewed retrospectively for etiology, clinical features, investigations, management, and outcome.Results: Out of total 53 cases of neonatal intestinal obstruction, 27 were of intestinal atresia (9 cases (17%) were of duodenal atresia, 7 (13%) were of jejunal atresia and 8 (13%) were ileal atresias and 3 cases were found with colonic atresia); 7 were malrotation, 17 were Hirschsprung’s disease (HD). All the patients were investigated with abdominal radiography and sonography. All patients were managed surgically. Overall mortality was 10/53 (18.8%). Out of 27 cases of atresia, 9 patients died (33% mortality). Septicemia was the cause of death in 7 patients (58.3%). Anastomotic leak was present in one mortality case.Conclusion: The most common cause of neonatal intestinal obstruction is atresia. Duodenal atresia was the most common atresia in our study followed by ileal atresia. Postoperative complications like septicemia led to most of deaths in our series. Septicemia, wound infection, hypothermia, prematurity need special attention for survival of neonates.

scholarly journals Recent Change in Management Pattern of Meconium Ileus at Dhaka Shishu Hospital

2018 ◽  
Vol 16 (2) ◽  
pp. 5-8
Author(s):  
Kazi Md Noor ul Ferdous ◽  
Md Samiul Hasan ◽  
Ashfaq Nabi ◽  
Md Arman Hossain ◽  
M Kabirul Islam ◽  
...  
Keyword(s):  
Intestinal Obstruction ◽  
Primary Anastomosis ◽  
Demographic Data ◽  
Intestinal Atresia ◽  
Recent Change ◽  
Meconium Ileus ◽  
T Tube ◽  
Before And After ◽  
Group A ◽  
Group B

Background : Meconium Ileus (MI) accounting for 9–33% of neonatal intestinal obstruction and one of the common cause of intestinal obstruction in neonate. Near about 50% can be present with various complications. Options for surgical management of MI include resection of dilated ileum with primary anastomosis, Bishop–Koop ileostomy, Santulli procedure or Mikulicz procedure and T tube ileostomy. In our center, before January 2015, mostly Mikulicz and few Bishop- Koop procedures were done for MI. But, the complications were high. From 2015, we started to perform T tube ileostomy and Bishop-Koop procedure in simple MI. In complicated cases Mikulicz and Bishop-Koop procedure were done and the scenario changed. This study was done to compare the outcome of MI surgery before and after January 2015.Methods: This was a retrospective study done in our center during January 2011 to December, 2016 (5 years). All cases were divided into two groups (Group-A: January 2011 to December 2014 and in Group-B: January 2015 to December 2016). Demographic data and surgical outcomes were compared.Results: Total 216 cases were included, in Group-A: 123 patients and others were in Group- B. Simple MI were 49% in Group-A and 56% were in Group-B. Complicated MI presented with small gut volvulus (43.3%) gangrene of loaded ileum (32.2%) perforation with peritonitis (37.8%) intestinal atresia with adhesions (16.3%) and meconium pseudocysts in 12 cases (16%). 11 patients had more than one complication. All the postoperative complications were found significantly high in Group-A except anastomotic leakage. Mortality was also significantly high in Group-A.Conclusion: Morbidity and mortality were significantly reduced with increasing practice of T tube ileostomy and Bishop-Koop procedure in simple and complicated Meconium ileus.Chatt Maa Shi Hosp Med Coll J; Vol.16 (2); July 2017; Page 5-8

scholarly journals Colonic Atresia and Hirschsprung's Disease: A Case Report from King Abdulaziz University Hospital

2015 ◽  
Vol 22 (1) ◽  
pp. 65-68
Author(s):  
Nouf Y. Akeel ◽  
Jamal S. Kamal ◽  
Aisha M. Abdulrahman
Keyword(s):  
Case Report ◽  
Anastomotic Leak ◽  
Hirschsprung's Disease ◽  
Hirschsprung’S Disease ◽  
Intestinal Atresia ◽  
University Hospital ◽  
Rare Form ◽  
Colonic Atresia ◽  
King Abdulaziz University

Atresia of the colon is a rare form among all types of intestinal atresia.  Further, the association between colonic atresia and aganglionosis is extremely rare; it may be easily overlooked due to the associated distal microcolon.  Management of a case of colonic atresia with distal aganglionosis presented with anastomotic leak due to unsuspected aganglionosis was discussed.  

scholarly journals Colonic Atresia: Association with Other Anomalies

2016 ◽  
Vol 5 (4) ◽  
pp. 47 ◽  
Author(s):  
Khaled M. El-Asmar ◽  
Mohammed Abdel-Latif ◽  
Abdel-Hamid A. El-Kassaby ◽  
Mohamed H. Soliman ◽  
Mosad M. El-Behery
Keyword(s):  
Hirschsprung's Disease ◽  
Hirschsprung’S Disease ◽  
Primary Anastomosis ◽  
Intestinal Atresia ◽  
Good Prognosis ◽  
Type I ◽  
Colonic Atresia ◽  
Type Iv ◽  
Low Incidence ◽  
Bowel Atresia

Background: Colonic atresia (CA) is a rare form of congenital intestinal atresia. Although CA may be isolated, it is more commonly reported in literature in association with other congenital anomalies.Materials and Methods: This study is a review of prospectively collected data of all the patients with colonic atresia presented to our center (Ain Shams University) during 2008 to 2016.Results: Twelve patients were enrolled in this study. The atresia was of type I in one case, type II in four cases, type IIIa in six cases, type IV in one case. These cases accounted for 4.9 % of intestinal atresias managed in our center during the same period. Five cases were isolated CA, while the other seven cases had associated abdominal congenital anomalies (exomphalos, Hirschsprung’s disease, imperforate anus, closing gastroschisis, colonic duplication, and multiple small bowel atresia in two cases). The management in ten cases was by staged procedure with creation of a temporary stoma initially, while primary anastomosis was established in two cases. We had two cases with delayed presentations, one missed diagnosis, and three mortalities in this series.Conclusions: The low incidence of CA may result in delay in the diagnosis and management. Hirschsprung’s disease should be excluded in every case of colonic atresia. Early diagnosis and proper surgical management is essential for good prognosis.

scholarly journals Gallbladder Duplication Associated with Gastro-Intestinal Atresia

2016 ◽  
Vol 5 (2) ◽  
pp. 14 ◽  
Author(s):  
Rahul Gupta ◽  
Shilpi Gupta ◽  
Pramila Sharma ◽  
Anu Bhandari ◽  
Arun Kumar Gupta ◽  
...  
Keyword(s):  
Intestinal Atresia ◽  
Duodenal Atresia ◽  
The Other ◽  
Ileal Atresia ◽  
Rare Entity ◽  
Pyloric Atresia ◽  
Colonic Atresia ◽  
Gallbladder Duplication

Gallbladder duplication in association with other GIT anomalies is a rare entity. We report two neonates; one with duodenal atresia and the other newborn with pyloric atresia, ileal atresia and colonic atresia, both were associated with gallbladder duplication which has not been reported earlier.

scholarly journals 273 The Consequences of a Failed Screening Programme

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
M Sharrock ◽  
C Whelton ◽  
R Paton
Keyword(s):  
Screening Programme ◽  
Demographic Data ◽  
Late Presentation ◽  
Developmental Dysplasia ◽  
Late Diagnosis ◽  
Operation Rate ◽  
Increasing Trend ◽  
The Uk ◽  
Clinical Records ◽  
Surgical Treatments

Abstract Introduction Controversy exists surrounding the efficacy of the UK screening programme for developmental dysplasia of the hip (DDH). Method Clinical records were reviewed in children who were treated surgically for DDH. Demographic data, age and mode of presentation, and surgical treatments were analysed, as well as outcomes, re-operation rate and AVN incidence. Late diagnosis was defined as greater than 4 months. Results 106 children (16 male, 90 female) underwent surgery from 1997 to 2018. 95 hips were operated for dislocation and 22 were operated for dysplasia. 13 patients had bilateral dislocations. Of the dislocated hips, the median age at diagnosis was 9 months (IQR 2-19). 56% were diagnosed late. In the late diagnosis group the median age for diagnosis was 19 months (IQR 15-21). We have identified an increasing trend in late presentation in recent years. This has been matched with an increasing trend in operation rates for dislocation per 1000 births. Conclusions This study demonstrates that DDH is being diagnosed increasingly late, which correlates with an increased need for surgical management. This suggests that the current UK screening programme is failing to identify children with DDH in a timely fashion, which necessitates more aggressive surgical treatment and less favourable outcomes.

scholarly journals Outcome of intussusception among children in Kano

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Lawal B. Abdullahi ◽  
Mohammad A. Mohammad ◽  
Lofty-John C. Anyanwu ◽  
Mohammad S. Aliyu ◽  
Bilya I. Liman
Keyword(s):  
Intestinal Obstruction ◽  
Demographic Data ◽  
Length Of Hospital Stay ◽  
Wound Dehiscence ◽  
Exploratory Laparotomy ◽  
Late Presentation ◽  
Adjacent Segment ◽  
Common Cause ◽  
A Prospective Study ◽  
Resection And Anastomosis

Intussusception is defined as the telescoping of a segment of the gastrointestinal tract within the lumen of the adjacent segment usually proximal to distal. It is a common cause of intestinal obstruction in children, rarely it can occur in adult. This condition is reported in both developed and developing countries, however there are few publications in Nigeria about the incidence, presentation and outcome of its management, most especially in children. This is a prospective study of pediatric patients managed in single center Kano over a period of 18months. The demographic data, clinical features, treatment and outcome of the management were evaluated and analyzed using SPSS version 23. Between June 2018 to December 2019, twenty-five children were managed with intussuception at Aminu Kano Teaching Hospital, there were 16 males and 9 females. The age of the patients ranges between 5 months to 6 years with most of patients in the ager range between 6 and 12 months. All of the 25 patients had exploratory laparotomy with manual reduction in 12 patients, while 13 patients had resection and anastomosis. Non-operative reduction using normal saline under ultrasound guidance was attempted for 2 patients, which was not successful. The length of hospital stay ranged between 4 days and 22 days. Few complications were observed which includes surgical site infection, wound dehiscence, postoperative ileus. One patient was re-operated for recurrent intussuception. Two patients died post operatively, while 23 patients were discharged home alive. Intussuception is still a common cause of intestinal obstruction in children in Kano. Late presentation was found to be associated with higher morbidity (complications).

scholarly journals Neonatal intestinal obstruction: report

2000 ◽  
Vol 6 (1) ◽  
pp. 187-193
Author(s):  
G. A. Nasir ◽  
S. Rahma ◽  
A. H. Kadim
Keyword(s):  
Mortality Rate ◽  
Conservative Treatment ◽  
Intestinal Obstruction ◽  
Imperforate Anus ◽  
Surgical Intervention ◽  
Duodenal Atresia ◽  
Colonic Atresia ◽  
Neonatal Intestinal Obstruction ◽  
Age Range ◽  
Surgical Unit

We reviewed 36 cases of neonatal intestinal obstruction admitted to our surgical unit over a 10-year period, 1986-1996, for surgical intervention following the failure of conservative treatment. There were more males than females and the age range was 12 hours-26 days. Imperforate anus was the main cause of the obstruction [27.8%] followed by duodenal atresia [13.9%] and colonic atresia and meconium ileus [11.1% each]. There were 8 deaths following surgery [22% mortality rate], the main causes being aspiration pneumonia, septicaemia and hypothermia

Intrauterine Intussusception Presenting as Fetal Ascites and Meconium Peritonitis

2021 ◽  
Vol 5 (0-2) ◽  
pp. 18
Author(s):  
Khalilah Alhuda Binti Kamilen ◽  
Mohd Yusran Othman
Keyword(s):  
Primary Anastomosis ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Intestinal Atresia ◽  
Premature Baby ◽  
Abdominal Radiograph ◽  
Meconium Peritonitis ◽  
Ileal Perforation ◽  
Intraabdominal Sepsis ◽  
Intrauterine Intussusception

Intussusception is a well-known cause of intestinal obstruction in children. Its occurrence in fetus as an intrauterine incidence is extremely rare and poses a diagnostic difficulty. Intrauterine intussusception may result in intestinal atresia once the gangrenous segment resorbed. However, a very late occurrence of intussusception just prior to delivery may present as meconium peritonitis. We are reporting a case of premature baby who was born at 35 weeks gestation via emergency caesarean for breech in labour. Routine scan 4 days prior to the delivery showed evidence of fetal ascites. She was born with good Apgar Score and weighed 2.5kg. Subsequently she developed respiratory distress syndrome requiring mechanical ventilation. She passed minimal meconium once after birth then developed progressive abdominal distension and vomiting. Abdominal radiograph on day 4 of life revealed gross pneumoperitoneum and bedside percutaneous drain was inserted to ease the ventilation. Upon exploratory laparotomy, a single ileal perforation was seen 20cm from ileocecal junction with an intussusceptum was seen in the distal bowel. Gross meconium contamination and bowel edema did not favour the option of primary anastomosis, thus stoma was created. Reversal of stoma was performed a month later and she recovered well. Fetus with a complicated intrauterine intussusception may present with fetal ascites and their postnatal clinical and radiological findings need to be carefully assessed for evidence of meconium peritonitis; in which a timely surgical intervention is required to prevent the sequelae of prolonged intraabdominal sepsis in this premature baby.International Journal of Human and Health Sciences Supplementary Issue-2: 2021 Page: S18

scholarly journals A Minor Innovation in Constructing a Small Bowel Stoma in Neonates with Small Bowel Atresia to Reduce the Morbidity

2016 ◽  
Vol 5 (4) ◽  
pp. 45 ◽  
Author(s):  
Naeem Khan ◽  
Saba Bakht ◽  
Nadia Zaheer
Keyword(s):  
Small Bowel ◽  
Primary Anastomosis ◽  
Intestinal Atresia ◽  
Stoma Formation ◽  
New Type ◽  
Small Bowel Atresia ◽  
Bowel Atresia ◽  
A Minor ◽  
Lost To Follow Up

Background: Intestinal atresia has still significant morbidity in developing countries. Stomas are now not recommended in every case of intestinal atresia; primary anastomosis is the goal of surgery after resection of dilated adynamic gut. A new type of stoma formation along with primary anastomosis is being presented here.Materials and Methods: This report is based on our experience of many cases with this technique in last 12 years but all the details and long follow-up of each case is not available. However the method of surgical procedure, progress, complications, and advantages encountered have been highlighted.Results: Presently we have data of 7 patients; others are lost to follow up. Three had died with other associated problems, namely one with multiple atresias, two with septic shock and prematurity. Two stomas did not require formal closure because stoma shriveled and disappeared. Two other stomas had grown very long like a diverticulum when these were closed after 5 and 8 months.Conclusion: This technique is another attempt to decrease morbidity of patients of intestinal atresia especially in those cases where short bowel syndrome is feared after resection of proximal dilated gut.

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