SMALL GUT ATRESIA IN NEONATES

Authors

  • Arshad Kamal
  • Kifayat Khan
  • Inayat ur Rahman
  • Ayub Khan

Abstract

Background: Small gut atresia is a common neonatal surgical problem. Early diagnosis and timelymanagement of the neonate can reduce mortality and morbidity in these patients. The aim of thisstudy was to note the causes of mortality and morbidity in these neonates. Methods: This was aprospective study conducted at Lady Reading Hospital (LRH) Peshawar from August 2007 toAugust 2009. All patients with small gut atresia were included in this study. Neonates havingintestinal obstruction due to another cause were excluded from this study. The diagnosis of small gutatresia was usually established peroperatively as other causes of intestinal obstruction like meconiumileus or meconium plug syndrome etc. in neonatal period mimic small gut atresia. Results: A totalof 40 neonates with small gut Atresia were included in this study. Among them 28 were males and12 were females. Age of presentation ranged from 1 to 8 days. Weight of the neonates ranged from1.8–2.8 Kg with the mean weight of 2.43 Kg. Peroperatively type-III(a) Atresia was the commonesttype 20 (50%). Resection and end to end anastomosis was done in 31 cases. Nine neonates neededileostomy. Financial constraints, late presentation, aspiration, sepsis, gut perforation and gangrenewere the main contributors to death of these neonates. Conclusion: Neonates having small gutatresia should be treated at a centre equipped for dealing neonates during all stages of management.Keywords: Small gut atresia, Management, Neonate

References

Adeniran JO, Odebode TO. Congenital malformations in

pediatric and neurosurgical practice: Problems and pattern (A

preliminary report) Sahel Med J 2005;8:4–8.

Goulet O, Baglin-Gobet S, Talbote C, Fourcade L, Colomg V,

Sauvatss F. Outcome and long term growth ofetr extensive small

bowel resection in neonatal period.A survey of 87 children. Eur J

Pedtr Surg 2005;15:95–101.

Couper ID, Thurley JD, Hugo JF. The neonatal resuscitation

training project in rural South Africa. Rural Remote Health

;5:459–63.

Sowande OA, Ogundoyo OO, Adeguyingbe O. Pattern and

factors affecting management outcome of neonatal emergency

surgery in Ile-Ife, Nigeria. Surg Pract 2007;11:71–5.

Osifo OD, Oriaifo IA. Factors affecting the management and

outcome of neonatal surgery in Benin City, Nigeria. Eur J

Paedatr Surg 2008;18;107–10.

Faponle AF, Sowonde OA, Adejuyingbe O. Anaesthesia for

neonatal surgical emergencies in a semi urban hospital in Nigeria.

East Afr Med J 2004;81:568–73.

Ameh EA, Ameh N. Providing safe surgery for neonates in sub

Saharan Africa. Trop Doct 2003;33:145–7.

Aidlen J, Anupindi SA, Jaramillo D, Doody DP. Malrotation

with midgut volvulous: CT findings of bowl infarction. Paedatr

Radiol 2005;35:529–31.

Sweeney B, Surana R, Puri P. Jejunoileal atresia and associated

malformations. Correlation with the timing of in utero insult. J

Paedatr Surg 2006:36:774–6.

Rottgen R, Ocran K, Lochs H, Hannm B. Cinematographic

techniques in diagnostics of intestinal diseases using MRI

enteroclysma. Clin Imaging 2009;33(1):25–32.

Piper HG, Alesbury J, Waterford SD, Zurakowski D, Jaksic T.

Intestinal atresia: Factors affecting clinical outcomes. J Pedeatr

Surg 2008;43(7):1294–8.

Walker GM, Raine PA. Bilious vomiting in new born: How

often is further investigation undertaken? J Pediatr Surg

;42:714–6.

Walker GM, Neilson A, Young D, Raina PA. Colour of bile

vomiting in intestinal obstruction in new born questionnaire

study. BMJ 2006;332:1363.

Aslenabadi S, Ghalehgolab-Behbahan A, Jamshidi M, Veisi P,

Iran SZ. Intestinal malrotations: A review and report of 30 cases.

Folia Morphol (Warsz) 2007;66:227–82.

Grant HW, Parker MC, Wilson MS, Menzies D, Sunderland G,

Thompson JN, et al. Adhesions after abdominal surgery in

children. J Pediatr Surg 2008;43:152–6; ;discussion 156–7.

Young JY, Kim DS, Muratore CS, Kurkchubasche AG,

Tracy TF Jr, Luks FJ. High incidence of post operative bowl

obstruction in newborns and infants. J Pediatr Surg

;42:962–5.

Desilva NT, Young SA, Wales PW. Understanding neonatal

bowel obstruction building knowledge to advance practice.

Neonatal Netw 2006;25(5):303–18.

Shau SL, Su BH, Lin KJ, Lin H C, Lin JN. Possible effect of

probiotics and breast milk in short bowel syndrome: report of one

case. Acta Paediatr Taiwan 2007;48(2):89–92.

Lin CH, Wu SF, Lin WC, Chen AC. Meckel’s diverticulum

induced intrauterine intussusception associated with ileal atresia

complicated by meconium peritonitis. J Formos Med Assoc

;106:495–8.

Chaudhory MS, Grant HW. Small bowel obstruction due to

adhesions following neonatal laparotomy. Pediatr Surg Int

;22:729–32.

Rygl M, Skaba R, Lisy J, Pycha K. Acute gastrointestinal

obstruction as a late presentation of congenital diaphragmatic

hernia. A report of 3 cases. Acta Chir Belg 2006;106:430–2.

Haiden N, Jilma B, Gerhold B, Klebermass K, Prusa AR, Kuhle

S, et al. Small volume enemas do not accelerate meconium

evacuation in very low birth weight infants. J Pediatr

Gastroenterol Nutr 2007;44(2):270–3.

Shinohara T, Tsuda M, Koyama N. Management of meconiumrelated ileus in very low birth weight infants. Pediartr Int

;49:641–4.

Hirata T, Iwaler M, Nagasaka M, Katada K. X-ray examination

of small intestine —conventional eneroclysis and CT

enterography. Nippon Rinsho 2008;66:1259–67.

Borsellino A, Zaccara A, Nahom A, Trucchi A, Aite L,

Giorlandino C, et al. False-positive rate in prenatal diagnosis of

surgical anomalies. J Pediatr Surg 2006;41:826–9.

Cassart M, Massez A, Lingier P, Absil AS, Donner C, Avni F.

Sonographic prenatal diagnosis of malpositioned stomach as a

feature of uncomplicated intestinal malrotation. Pediatr Radiol

;36(4):358–60.

Pratap A, Kaur N, Shakya VC, Sapkota G, Tanveer-ur Rahman

S, Biswas BK, et al. Triple tube therapy: a novel enteral feeding

technique for short bowel syndrome in low-income countries. J

Pediatr Surg 2007;42:470–3.

Published

2010-06-01