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

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

scholarly journals Neonatal intestinal obstruction : patterns, problems and outcome

2013 ◽  
Vol 45 (1-2) ◽  
pp. 6-10 ◽  
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

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

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.

Modified Duhamel Retrorectal Pull-Through for Hirschsprung’s Disease

2021 ◽  
Vol 15 (10) ◽  
pp. 2886-2889
Author(s):  
Shafiq ur Rehman ◽  
Muhammad Anwar ◽  
Zarlish Fazal
Keyword(s):  
Hirschsprung's Disease ◽  
Hirschsprung’S Disease ◽  
Operation Time ◽  
Clinical Score ◽  
Toilet Training ◽  
Paediatric Surgery ◽  
Short Term ◽  
Female Ratio ◽  
Bowel Habits ◽  
Pull Through

Objectives: To evaluate the post-operative complications and short-term outcomes of modified Duhamel retrorectal pull-through procedure for Hirschsprung’s disease. Design: Prospective descriptive study Place and Duration of Study: Department of Paediatric Surgery Sahiwal Teaching Hospital Sahiwal from 1stJanuary 2018 to 31st December 2020. Methodology: Thirty seven histologically confirmed cases of Hirschsprung’sdisease having previous decompressing colostomy/stoma age between 1 to 12 years of agewere included. Children under one year of age, with sever comorbidities like Down syndrome and cardiac abnormalities, and those who require re-do pull through procedure were excluded. Modified Duhamel retrorectal pull-through procedure was performed in all cases. The demographic information included age, sex, proximal level of aganglinosis, complications of definite procedure, length of hospitalization andmortality. Other information recorded included long term complications like obstructive symptoms, enterocolitis, incontinence and soiling at follow up. Krickenbeck classification was used to evaluate faecal incontinence and constipation. Kelly’s clinical score was used to assess the anal sphincter. Bowel habits were assessed only in children above three years of age. Results: Twenty six (70.27%) were males and 11 (29.72%) females with male to female ratio 2.3:1 and mean age at operation was 2.89±1-9 years. Twenty nine (78.37%) children were ≤3 years of age and 8 (21.62%) were >3 years. Mean weight was 12.91 kgs, operation time was 126.81 time, fasting time was 6.67 days and hospital stay was 11.91 days. Length of aganglionic segment was short segment 27 (72.97%), long segment 9 (24.32%) and total colonic 1 (2.7%). Hirschsprung associated enterocolitis 7 (18.91%) and wound infection 6(16.21%) were most common reported complications. Constipation in 5(13.51) and soiling with retentive constipation was present in 3 (8.10%) patients. Out of total 31 patients who reached toilet training age, 28 (90.32%) developed satisfactory voluntary bowel habits. Conclusion: Modified Duhamel pull-through procedure was found to be safe, applicable and with lower associated complications and satisfactory short term functional outcomes in our settings. Key words: Hirschsprung’s disease, Modified Duhamel pull-through procedure, Complications, Outcomes

scholarly journals Neonatal Intestinal Obstruction: When to Suspect Duplication Cyst of Bowel as the Cause

2016 ◽  
Vol 5 (4) ◽  
pp. 52 ◽  
Author(s):  
Rizwan Ahmad Khan ◽  
Shagufta Wahab ◽  
Imran Ghani
Keyword(s):  
Intestinal Obstruction ◽  
Clinical Presentation ◽  
Duplication Cyst ◽  
Paediatric Surgery ◽  
College Hospital ◽  
Diagnostic Modality ◽  
Medical College ◽  
Common Location ◽  
Neonatal Intestinal Obstruction ◽  
Subsequent Event

Background: Duplication cyst is a rare cause of neonatal intestinal obstruction. Their most common location is the small intestine. The clinical presentation is extremely variable depending upon its size, location and type and the age of the patient and are mainly encountered during infancy or early childhood. The diagnosis is very difficult in neonates. This study was undertaken to study their presentation, diagnostic modality of choice and further management in neonatal age group.Materials and Methods: This was a retrospective study performed at the Department of Paediatric Surgery, J .N Medical College Hospital, AMU Aligarh from July 2008 to June 2014. The data was analyzed with respect to demographic profile of the neonates, their initial clinical presentation, radiological features and subsequent event leading to intervention, operative features and outcome.Results: There were a total of seven neonates between ages of 3 days and 21 days who were diagnosed as cases of intestinal obstruction due to duplication cyst. The majority of the patients were having ileal duplication cyst (n=4). Ultrasonography played important role in majority of the cases for diagnosis. There was one patient in which the diagnosis was confused with ileal atresia. All the patients underwent excision with restoration of bowel continuity.Conclusion: The diagnosis of intestinal obstruction in neonate due to duplication cyst is difficult. It has varied presentation and preoperative diagnosis at times may be challenging. Surgery is the mainstay of the treatment.

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

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

scholarly journals The follow-up of the robotic-assisted Soave procedure for Hirschsprung’s disease in children

2021 ◽  
Author(s):  
Tran Anh Quynh ◽  
Pham Duy Hien ◽  
Le Quang Du ◽  
Le Hoang Long ◽  
Nguyen Thi Ngoc Tran ◽  
...  
Keyword(s):  
Hirschsprung's Disease ◽  
Hirschsprung’S Disease ◽  
Pediatric Patients ◽  
Three Dimensional ◽  
Dentate Line ◽  
Robotic Arms ◽  
Robotic Assisted ◽  
The Mean ◽  
Pull Through

AbstractRobotic surgery offers three-dimensional visualization and precision of movement that could be of great value to gastrointestinal surgeons. There were many previous reports on robotic technology in performing Soave colonic resection and pull-through for Hirschsprung’s disease in children. This study described the follow-up of the Robotic-assisted Soave procedure for Hirschsprung’s disease in children. Robotic-assisted endorectal pull-through was performed using three robotic arms and an additional 5-mm trocar. The ganglionic and aganglionic segments were initially identified by seromuscular biopsies. The rest of the procedure was carried out according to the Soave procedure. We left a short rectal seromuscular sleeve of 1.5–2 cm above the dentate line. From December 2014 to December 2017, 55 pediatric patients were operated on. Age ranged from 6 months to 10 years old (median = 24.5 months). The aganglionic segment was located in the rectum (n = 38), the sigmoid colon (n = 13), and the left colon (n = 4). The mean total operative time was 93.2 ± 35 min (ranging from 80 to 180 min). Minimal blood was lost during the surgery. During the follow-up period, 41 patients (74.6%) had 1–2 defecations per day, 12 patients (21.8%) had 3–4 defecations per day, and 2 patients (3.6%) had more than 4 defecations per day. Fecal incontinence, enterocolitis, and mild soiling occurred in three (5.4%), four (7.3%), and two pediatric patients, respectively. Robotic-assisted Soave procedure for Hirschsprung’s disease in children is a safe and effective technique. However, a skilled robotic surgical team and procedural modifications are needed.

scholarly journals Closed Gastroschisis

2017 ◽  
Vol 6 (3) ◽  
pp. 61 ◽  
Author(s):  
Mohammed Abdel-Latif ◽  
Mohamed Hisham Soliman ◽  
Khaled Mohaned El-Asmar ◽  
Mohamed Abdel-Sattar ◽  
Ibrahim M Abdelraheem ◽  
...  
Keyword(s):  
Intestinal Obstruction ◽  
Short Bowel Syndrome ◽  
Intestinal Atresia ◽  
Rare Entity ◽  
Short Bowel ◽  
Neonatal Intestinal Obstruction

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.

scholarly journals Early and long-term complications following transanal pull through Soave technique in infants with Hirschsprung's diseaseric infants with Hirschsprung's disease

2019 ◽  
Author(s):  
Manoochehr Ghorbanpour ◽  
Mohammad Ali Seyfrabie ◽  
Babak Yousefi
Keyword(s):  
Intestinal Obstruction ◽  
Hirschsprung's Disease ◽  
Hirschsprung’S Disease ◽  
Statistical Tests ◽  
Case Series ◽  
P Value ◽  
Short Term ◽  
Case Series Study ◽  
The Mean

Objective. Patients undergoing Soave surgery for Hirschsprung's disease are at risk for some complications. The aim of this study was to investigate such short-term and long-term complications and evaluate the outcome of the operation in these patients. Methods. A case series study was carried out during the last 12 years, during 2007 to 2018 in Besat hospital of Hamadan. Data collection conducted using a checklist includes questions about demographic information, clinical features, and short-term and long-term complications, and consequences of post-operative surgery. The findings of the study were analyzed using SPSS software version 20 and appropriate statistical tests. P-value less than 0.05 was considered statistically significant. Results. A total of 55 children underwent Soave surgery during the last 12 years in Besat Hospital Hamadan, Iran. The mean age of the patients was 38±10 days during surgery, of which 56.4% were female. The mean hospital stay was 7.3 days. Also, the mean weight of children at birth was 2970±447 gr. Most of the patients were born as NVD (52.7%) and term (74.5%). The most common comorbidity was congenital heart disease. The most common short-term complication was intestinal obstruction in 14 patients (25.5%) and the most frequent long-term complication was intestinal obstruction and constipation (27.3% each cases). The mortality rate of patients in this study was 14.5% in total. Conclusions. One stage surgical procedure in Hirschsprung's disease is a safe and effective method, but care should be taken in choosing patients and patients should be monitored for possible complications, so that they can be considered and implemented for proper treatment.

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