Clinic-etiologic profile of pediatric patients with intestinal obstruction and its association with age and gender

Abstract

Aim: to find out various etiologies, clinical features, outcome and mortality of paediatric age groups with intestinal obstruction and their relation to age and sex distribution. Materials and methods: This was a prospective study conducted in the Department of Paediatrics surgery Patna Medical College and Hospital, Patna Bihar, India for 13 months. Out of 100, 48 patients were neonates (1-7 days), 15 patients were infants (1 months-1 year) and 37 patients were children (1-14 years) who presented with symptoms and signs of intestinal obstruction and diagnosis confirmed by x-ray abdomen or invertogram were included in this study. Complete blood count, serum electrolyte and urea level were done. Results: Highest incidence of intestinal obstruction in 48 neonates (48%) of age group of 1-7days followed by 15 infants of 1 months-1 years (15%) and 37 children of age 1 years -14 years (37%). out of 100, 64 were males (64%) and 36 females (36%). Abdominal distension in 68(68%) patients which was found to be a commonest symptom followed by failure to pass meconium in 65 (65%) patients, excessive crying in 61 (61%) patients, abdominal pain in (31%) patients, visible peristalsis in 5 (5%) patients and vomiting in 39 (39%) patients. Out of 100, 80 (80%) patients had congenital causes in which 40 (40%) patients had imperforate anus followed by Hirschprung’s disease in 17(17%) patients, Meckel’s diverticulum in 13(13%) patients, jejunal atresia in 7 (7%) patients and hypertrophic  pyloric  stenosis  in  3  (3%)  patients  and acquired causes were seen in 20 (20%) patients in which intussusceptions in 12 (12%) patients, abdominal tuberculosis  in  5  (5%)  and  gangrenous  appendix  in  3 (3%) patients. Overall postoperative complications occurred in 27 (27%) patients. Conclusions: we conclude that the congenital causes of intestinal obstruction were more common (80%) than the acquired causes (20%). Postoperative septicaemia was more common and overall mortality was exclusively in neonates.

Keywords: Anorectal malformation, Intestinal obstruction, Intussusception, Intestinal atresia, Neonate.