Pediatric Intestinal Obstruction in Children Less Than 12 Years – Observational Study in a Tertiary Care Hospital and Review of Literature
Authors/Creators
- 1. Associate Professor, Department of Pediatric Surgery, Siddhartha Medical College, Vijayawada, Andhra Pradesh
- 2. Assistant Professor, Department of Pediatric of Pediatric Surgery, Siddhartha Medical College, Vijayawada, Andhra Pradesh
Description
Aim: To study the clinical presentation, the demography, etiology, presenting features, management and outcome of intestinal obstruction in pediatric population of age less than 12 years over a period of 1.5 years in a tertiary care institute. Materials and Methods: It is a retrospective observational study of children presented with intestinal obstruction managed over a period of 1.5 years from June 2022 to December 2023 at Department of pediatric surgery Siddhartha medical college and hospital, Vijayawada. All children admitted into the department of pediatric surgery with a diagnosis of acute intestinal obstruction were studied. Neonatal cases (children age less than one month), Children with age more than 12 years and cases with paralytic ileus were excluded from current study. Cases were diagnosed by clinical features, x-ray erect abdomen. All children were subjected for serological examination for dys-electrolytemia. Contract enhanced computed tomogram (CECT) was demanded for cases in suspicion. Hospital records were verified and analysed using MS office professional 2013 and SPSS software version 29. Results: a total of 67 cases were managed for intestinal obstruction during the period of study. Male children (n=41) are effected most commonly. Pain abdomen was the most common presenting complaint followed by bilious vomiting and distension of the abdomen. Shock and dys-electrolytemia were among the complaints in 6 and 12 cases respectively. The commonest etiology identified was adhesions and congenital bands (n=23) in the present study followed by Intussusception. Trichobezor was the least common cause seen in only one child. All children were managed surgically. 2 cases succumbed to death due to continued dyselectrolytemia and shock in the present study. Conclusions: Intestinal obstruction is one of the common Pediatric Surgical emergency accounting for nearly 15% of the admissions at our center. The incidence is higher in males than in females. Abdominal pain, vomiting, abdominal distention and constipation are the predominant presenting symptoms. Adhesions and Congenital bands are the commonest type of intestinal obstruction 34.3%. Intussusception 28.3% and Malrotation 8.9% are the next common types in our study. Mortality is significantly higher in those who present late (>72hrs) than in those presenting between 24 to 72hrs. Mortality was noted in patients presenting late with signs of peritonitis, septicemic shock, gangrene of the bowel and perforation. Early diagnosis, correction of dyselectrolytemia and shock and timely surgical management can prevent gangrene of bowel and reduce mortality.
Abstract (English)
Aim: To study the clinical presentation, the demography, etiology, presenting features, management and outcome of intestinal obstruction in pediatric population of age less than 12 years over a period of 1.5 years in a tertiary care institute. Materials and Methods: It is a retrospective observational study of children presented with intestinal obstruction managed over a period of 1.5 years from June 2022 to December 2023 at Department of pediatric surgery Siddhartha medical college and hospital, Vijayawada. All children admitted into the department of pediatric surgery with a diagnosis of acute intestinal obstruction were studied. Neonatal cases (children age less than one month), Children with age more than 12 years and cases with paralytic ileus were excluded from current study. Cases were diagnosed by clinical features, x-ray erect abdomen. All children were subjected for serological examination for dys-electrolytemia. Contract enhanced computed tomogram (CECT) was demanded for cases in suspicion. Hospital records were verified and analysed using MS office professional 2013 and SPSS software version 29. Results: a total of 67 cases were managed for intestinal obstruction during the period of study. Male children (n=41) are effected most commonly. Pain abdomen was the most common presenting complaint followed by bilious vomiting and distension of the abdomen. Shock and dys-electrolytemia were among the complaints in 6 and 12 cases respectively. The commonest etiology identified was adhesions and congenital bands (n=23) in the present study followed by Intussusception. Trichobezor was the least common cause seen in only one child. All children were managed surgically. 2 cases succumbed to death due to continued dyselectrolytemia and shock in the present study. Conclusions: Intestinal obstruction is one of the common Pediatric Surgical emergency accounting for nearly 15% of the admissions at our center. The incidence is higher in males than in females. Abdominal pain, vomiting, abdominal distention and constipation are the predominant presenting symptoms. Adhesions and Congenital bands are the commonest type of intestinal obstruction 34.3%. Intussusception 28.3% and Malrotation 8.9% are the next common types in our study. Mortality is significantly higher in those who present late (>72hrs) than in those presenting between 24 to 72hrs. Mortality was noted in patients presenting late with signs of peritonitis, septicemic shock, gangrene of the bowel and perforation. Early diagnosis, correction of dyselectrolytemia and shock and timely surgical management can prevent gangrene of bowel and reduce mortality.
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IJPCR,Vol16,Issue2,Article11.pdf
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Additional details
Dates
- Accepted
-
2024-01-26
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/16/IJPCR,Vol16,Issue2,Article11.pdf
- Development Status
- Active
References
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