Closed Gastroschisis

Closed gastroschisis is a rare entity usually associated with intestinal atresia and short bowel syndrome. We report two cases of closed gastroschisis presenting with neonatal intestinal obstruction and para-umbilical evisceration without an abdominal defect.

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Multiple intestinal anastomoses to avoid short bowel syndrome and stimulate bowel maturity in type IV multiple intestinal atresia and necrotizing enterocolitis

Journal of Pediatric Surgery ◽

10.1016/j.jpedsurg.2011.12.027 ◽

2012 ◽

Vol 47 (3) ◽

pp. 628 ◽

Cited By ~ 8

Author(s):

Emmanuel Sapin ◽

Luc Joyeux

Keyword(s):

Short Bowel Syndrome ◽

Necrotizing Enterocolitis ◽

Intestinal Atresia ◽

Intestinal Anastomoses ◽

Short Bowel ◽

Type Iv ◽

Multiple Intestinal Atresia

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Nutritive support in short Bowel syndrome (sbs)

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh0302077s ◽

2003 ◽

Vol 131 (1-2) ◽

pp. 77-81 ◽

Cited By ~ 2

Author(s):

Dusica Simic ◽

Nebojsa Djurisic

Keyword(s):

Short Bowel Syndrome ◽

Age Of Onset ◽

Intestinal Atresia ◽

Nutritional Deficiencies ◽

Current Therapy ◽

Normal Body Mass Index ◽

Short Bowel ◽

Gastric Acid Hypersecretion ◽

Acid Hypersecretion

Short bowel syndrome most commonly result after bowel resection for necrosis of the bowel. It may be caused by arterial or venous thrombosis, volvolus and in children, necrotizing enterocolitis. The other causes are Crohn,s disease intestinal atresia. The factors influencing the risk on short bowel syndrome are the remaining length of the small bowel, the age of onset, the length of the colon, the presence or absence of the ileo-coecal valve and the time after resection. Besides nutritional deficiencies there some other consequences of extensive resections of the small intestine (gastric acid hypersecretion, d-lactic acidosis, nephrolithiasis, cholelithiasis), which must be diagnosed, treated, and if possible, prevented. With current therapy most patients with short bowel have normal body mass index and good quality of life.

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Short Bowel Syndrome

10.2310/gastro.5448 ◽

2015 ◽

Author(s):

Robert Burakoff ◽

Alison Goldin

Keyword(s):

Small Intestine ◽

Short Bowel Syndrome ◽

Average Length ◽

Intestinal Failure ◽

Clinical Manifestations ◽

Intestinal Resection ◽

Intestinal Atresia ◽

Congenital Defects ◽

Short Bowel ◽

Vascular Insufficiency

Short bowel syndrome (SBS) is a state of malabsorption resulting from physical or functional loss of large portions of the small intestine, and is the most common cause of intestinal failure. The average length of a human’s small intestine is between 3 and 8 m, depending on the type of measurements made (surgical, radiologic, or autopsy); SBS occurs when less than 200 cm of small bowel remains. SBS may be congenital (intestinal atresia) or acquired. Physical losses usually occur from surgical resection for Crohn disease (CD), vascular insufficiency, radiation, malignancy, trauma, or volvulus. The site of intestinal resection helps to determine the degree of intestinal capacity. Functional losses, on the other hand, are less common and occur in the setting of a nonfunctioning, but intact, small intestine. Examples include radiation enteritis, congenital defects, and inflammatory bowel disease (IBD). This review addresses the epidemiology, pathophysiology and pathogenesis, clinical manifestations, treatment, complications, and prognosis of SBS. A figure shows sites of intestinal nutrient absorption. A table lists potential complications of SBS in patients receiving parenteral nutrition (PN). This review contains 1 highly rendered figure, 1 table, and 67 references.

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Congenital Neonatal Intestinal Obstruction: Retrospective Analysis at Tertiary Care Hospital

Journal of Neonatal Surgery ◽

10.21699/jns.v5i4.393 ◽

2016 ◽

Vol 5 (4) ◽

pp. 49 ◽

Cited By ~ 3

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.

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Patterns and Outcome of Neonatal Intestinal Obstruction in Kanti Children’s Hospital

Journal of Nepal Paediatric Society ◽

10.3126/jnps.v40i2.29254 ◽

2020 ◽

Vol 40 (2) ◽

pp. 120-124

Author(s):

Bijay Thapa ◽

Anupama Basnet

Keyword(s):

Survival Rate ◽

Intestinal Obstruction ◽

Anorectal Malformation ◽

Hirschsprung's Disease ◽

Hirschsprung’S Disease ◽

Intestinal Atresia ◽

Meconium Ileus ◽

Children's Hospital ◽

Surgical Emergency ◽

Neonatal Intestinal Obstruction

Introduction: Neonatal intestinal obstruction is the most common neonatal surgical emergency. More than 75% of neonatal surgeries are done for the correction of this problem. The outcome of this obstruction mainly depends upon the causes of obstruction, clinical condition of the patient, associated anomalies, expertise and centre where the patient is dealt. This study was undertaken to study the clinical features and outcome of neonatal intestinal obstruction presented in our centre. Methods: The medical records of all neonates admitted in the surgical NICU were selected and cases with the diagnosis of neonatal intestinal obstruction and managed surgically during two years period from September 1, 2015 to September 1, 2017 were retrospectively reviewed and analysed in regard to age at presentation, sex, weight, gestation, postoperative diagnosis and their outcome. Results: Out of 235 admitted neonates, 205 cases were treated surgically for intestinal obstruction. There were a total of 154 (75.2%) males and 51 (24.8%) females. Mean age at presentation was 4.5 days and average weight was 2.25 kg. Among them, anorectal malformation (ARM) 88 (42.92%), intestinal atresia 59 (28.78%), Hirschsprung’s disease 38 (18.53%), malrotation of gut 10 (4.87%) and meconium ileus 10 (4.87%) were the etiology. Among intestinal atresia, duodenal atresia 27 (45.76%) was the commonest one followed by ileal atresia 24 (40.67%), six jejunal atresia (10.16%) and two colonic atresia (3.38%). Overall, 160 neonates survived (78.04%). Among the survival, Hirschsprung’s disease was 34 (89.47%), ARM 78 (88.63%), seven malrotation of gut (70%), six meconium ileus (60%) and intestinal atresia 35 (59.32%). Conclusion: Neonatal intestinal obstruction is the most common neonatal surgical emergency in Kanti Children’s Hospital. Anorectal malformation was the commonest etiology followed by intestinal atresia and Hirschsprung’s disease. Overall survival rate was 78%. Cases with Hirschsprung’s disease and anorectal malformation had about 90% survival rate. Intestinal atresia was the major cause of mortality occupying 53.35% of total mortality of 21.95%. Mortality is mainly due to delayed diagnosis, referral and intervention which lead to higher complications of cases.

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Congenital short bowel syndrome: a rare cause of neonatal intestinal obstruction

Journal of International Medical Research ◽

10.1177/0300060520954726 ◽

2020 ◽

Vol 48 (9) ◽

pp. 030006052095472

Author(s):

Mostafa Zain ◽

Mansour Abdelkader ◽

Ahmed Azab ◽

Mostafa Kotb

Keyword(s):

Short Bowel Syndrome ◽

Failure To Thrive ◽

Gastrointestinal Disorder ◽

Chronic Diarrhoea ◽

Small Bowel Length ◽

Short Bowel ◽

Ileocecal Junction ◽

Intestinal Length ◽

Neonatal Intestinal Obstruction ◽

Ladd’S Procedure

Congenital short bowel syndrome (CSBS) is an uncommon gastrointestinal disorder in which an unclear aetiology causes considerable intrauterine reduction in small bowel length. As a result of reduced absorptive intestinal length, chronic diarrhoea, vomiting, and consequently, failure to thrive are likely. We report a case of CSBS in a 26-day-old girl who had malrotation and a short bowel with a length of bowel from the pylorus to the ileocecal junction of approximately 40 cm. The patient underwent Ladd’s procedure, but she is still dependent on parenteral nutrition.

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Neonatal intestinal obstruction : patterns, problems and outcome

Bangladesh Medical Journal Khulna ◽

10.3329/bmjk.v45i1-2.13638 ◽

2013 ◽

Vol 45 (1-2) ◽

pp. 6-10 ◽

Cited By ~ 1

Author(s):

Amar Kumar Saha ◽

Md Barkot Ali ◽

Sunil Kumar Biswas ◽

HM Zafor Sharif ◽

Anwerul Azim

Keyword(s):

Surgical Treatment ◽

Intestinal Obstruction ◽

Hirschsprung's Disease ◽

Hirschsprung’S Disease ◽

Intestinal Atresia ◽

Postoperative Management ◽

Meconium Ileus ◽

College Hospital ◽

Female Ratio ◽

Neonatal Intestinal Obstruction

Neonatal intestinal obstruction is the most common surgical emergency in newborn. Ideally neonatal surgery should be done in an organized neonatal surgical unit. This study was done mostly in general surgical setup in Khulna without any facility of NICU and TPN. The aim of this study was to detect the patterns of neonatal intestinal obstruction and to find out the problems and outcome of surgical treatment. This retrospective study was done between January 2008 and December 2010, in Khulna Medical College Hospital, Khulna Shishu Hospital and a private clinic in Khulna. A total of 205 neonates with intestinal obstruction were treated surgically. Babies of both sexes up to 28 days of age were included in this study. Common causes of neonatal intestinal obstruction were anorectal malformation (ARM), intestinal atresia, Hirschsprung's disease (HD), meconium ileus and malrotation of midgut. Male-female ratio was 1.6:1 and about 13% was premature. Out of 205 neonates, there were ARM-73, HD-47, meconium ileus-38, intestinal atresia-29, malrotation-13 and others-5. Total 172 (84%) survived. Those were ARM (94%), Hirschsprung's disease (91%), meconium ileus (79%), intestinal atresia (55%), malrotation of gut (85%) and others (40%). Overall mortality after initial surgical treatment was 16%. Prognosis of surgical treatment depends on early intervention, expert anaesthesia, associated anomaly and complication, gentle handling of delicate tissue and intensive postoperative management. Medical practitioners were the first attending physician in most instances. So both physicians and surgeons have a contributing role in reducing mortality. DOI: http://dx.doi.org/10.3329/bmjk.v45i1-2.13638 Bang Med J (Khulna) 2012; 45 : 6-10

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Neonatal Intestinal Obstruction Management: Ten Years Experience in Combined Military Hospital, Dhaka

Journal of Armed Forces Medical College Bangladesh ◽

10.3329/jafmc.v14i1.42716 ◽

2019 ◽

Vol 14 (1) ◽

pp. 24-28

Author(s):

Meherun Nessa ◽

Shams ud Din Elias Khan ◽

Abu Daud Md Shariful Islam ◽

Md Shakhawat Hossain

Keyword(s):

Intestinal Obstruction ◽

Neonatal Intensive Care ◽

Very Low Birth Weight ◽

Surgical Care ◽

Hirschsprung Disease ◽

Armed Forces ◽

Intestinal Atresia ◽

Military Hospital ◽

Female Ratio ◽

Neonatal Intestinal Obstruction

Introduction: Neonatal intestinal obstruction is the commonest surgical emergency in neonatal period. The outcome in neonatal intestinal obstruction has improved dramatically due to the improvements in diagnostic facilities and neonatal intensive care, and surgical advances. Objective: To detect the pattern of neonatal intestinal obstruction, to find out their cause and outcome after management. Materials and Methods: This was a 10 years retrospective review of all children aged 28 days and below, managed for intestinal obstruction between March 2006 and February 2016 at the Pediatric Surgical Division of Combined Military Hospital, Dhaka. Patients who were presented with septic shock, pneumonia, very low birth weight and extreme prematurity, Anorectal malformation were excluded from the study. Result: Out of 196 patients, male patients were 135(68.87%), female 61(31.12%) and male to female ratio was 2.2:1. Most common cause of intestinal obstruction was Intestinal atresia 55(28.08%) followed by Hirschsprung disease 45(22.93%), Meconium ileus 43(21%), Malrotation of gut 23(11.73%), duodenal atresia 12 (6.12%), gastroschisis 10(5.10%) and other case 8(4.01%). Majority of neonates 158(80.61%) presented within 1st week of life and survival rate was 83.16%. Mortality in preterm was much higher 19(70.35%) than in term newborns 21(12.42%). Conclusion: Dedicated delicate neonatal surgical care, early diagnosis and intervention are the crucial factors in improving operative outcome in neonatal surgery. Journal of Armed Forces Medical College Bangladesh Vol.14(1) 2018: 24-28

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Etiology and Treatment Outcome of Neona tal Intestinal Obstruction in a Tertiary Hospital

TAJ Journal of Teachers Association ◽

10.3329/taj.v22i2.37723 ◽

2009 ◽

Vol 22 (2) ◽

pp. 198-203

Author(s):

SS Islam ◽

MA Nowshad ◽

A Jator ◽

I Faisal ◽

M Ahmed

Keyword(s):

Intestinal Obstruction ◽

Hirschsprung's Disease ◽

Hirschsprung’S Disease ◽

Intestinal Atresia ◽

Paediatric Surgery ◽

College Hospital ◽

Female Ratio ◽

Neonatal Intestinal Obstruction ◽

Surgery Department

A prospective study was conducted on 54 cases of neonatal intestinal obstruction, admitted in Paediatric surgery department of Rajshahi Medical College Hospital during the period from January 2008 to December 2008, a period of 12 months. The objective of the study was to find out etiological aspect and outcome of admitted patient with neonatal intestinal obstruction. The patient constituted 33.7% of total neonatal admission in Paediatric surgery department during the study period. The male: female ratio was 1.4:1 with age ranging from 1 to 28 days. Birth weight of most of the patients was above 2 kg. Most of the patients came from poor and average family. Patients from poor family are slightly ahead. Plain x-ray abdomen was done in all cases in our study. Contrast radiography performed in selected cases. Ultrasound scan done to in selective case to rule out IHPS. No rectal biopsy was taken in case of suspected Hirschsprung's disease. The causes of neonatal intestinal obstruction were in order of frequency-Hirschsprung's disease (45.2%), Intestinal atresia (24.5%), malrotation (9.4%), bands & adhesion (5.6%), meconium ileus (5.6%), volvulus neonatarum (5.6%), meconium plug syndrome (1.8%), unknown (3.7%). 50 patients were treated operatively. 28.3% cases developed complications. Most of the complications were related to colostomy and sepsis. Overall mortality was 20.8%. Mortality was maximum in intestinal atresia. Every patient was advised to come for follow up at the time of discharge but most of the people did not report. In the study only 17 (32.1%) patient came for follow up as per advice.TAJ 2009; 22(1): 198-203

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