SMALL GUT ATRESIA IN NEONATES
AbstractBackground: 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
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
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
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
Walker GM, Raine PA. Bilious vomiting in new born: How
often is further investigation undertaken? J Pediatr Surg
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
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
Chaudhory MS, Grant HW. Small bowel obstruction due to
adhesions following neonatal laparotomy. Pediatr Surg Int
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
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
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.
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