Neonatal intestinal obstruction risk factors for morbidity and mortality at CHUK

Abstract

Background: Surgery in neonates is a challenging issue especially in developing countries. Obstruction in the newborn was almost always fatal in the past but significant advances in neonatal surgery have resulted in the improved survival of newborns with congenital malformation that were earlier considered lethal. A clear understanding of the clinical profile, diagnosis and risk factors for morbidity and mortality would improve the quality of care provided in resource limited settings. Objectives: We aimed at determining the factors influencing morbidity and mortality in neonates with intestinal obstruction admitted to the pediatric surgical unit at CHUK in order to define strategies to improve care. Methods: This was a prospective observatonal study including all neonates (0-28days) with intestinal obstruction who were admitted to the pediatric surgical unit at CHUK from April 2018 to March 2019. Results: Of 60 patients, 36 were males and 24 were females. Majority of neonates were born at term (93, 3%) and only 6, 7% were born pre-term. The mean age at presentation was 6 days. Anorectal malformation and Intestinal atresia were the most common diagnoses both occurring at 36, 6%. Hirschsprung disease (13, 3%) was the third most common cause of obstruction in neonates in our study. Colostomy was the most common procedure done in our study. Risk factors for morbidity among neonates with IO were admission weight, age at admission and ICU admission. Risk factors for mortality were gestational age, associated anomalies, ICU admission and complications after operation. Conclusion: Anorectal malformation and small intestinal atresia were the commonest causes of neonatal intestinal obstruction followed by Hirschsprung’s disease. Low number of associated anomalies has been reported. High rate of death were due to preventable causes such as sepsis.