Clinical outcome of intestinal obstruction in pediatric age group: A prospective study
Journal Title: INTERNATIONAL JOURNAL OF RECENT TRENDS IN SCIENCE AND TECHNOLOGY - Year 2016, Vol 20, Issue 2
Abstract
Background: Intestinal obstruction is one of the commonest cause of pediatric surgical emergency with a high morbidity and mortality. Very few previous studies address the problem regarding clinical outcome of these patients especially in Indian context. Materials and Methods: A two year (April 2011 to June 2013) prospective study of hundred consecutive pediatric intestinal obstruction cases aged 1 day to 12 yrs presenting at RCSMGMC and CPR hospital, Kolhapur was done to assess the pattern and factors affecting the outcome. Results: Hundred (100) children with male to female ratio of 1.1:1 were seen during study with peak incidence seen in neonates (40). The median duration of symptoms was 48 hrs (range 1hr to 10 days) with 52% of the delayed cases (more than 48 hrs) being previously treated symptomatically and referred. In present study, Intussusception was the commonest cause of obstruction in 20% of patients. Anorectal malformations were close second with total incidence of 19% followed by Hirschsprung’s disease (16%), Intestinal Atresias (8%), Adhesive obstruction (7%),Necrotizing enterocolitis (7%). Perforative peritonitis, Congenital Hypertrophic Pyloric Stenosis, Intestinal Malrotation, Meckel's Diverticulitis, Obstructed Exemphalos and worm obstruction were seen in 3% patients each. Obstructed Inguinal hernia (2%), Umbilical Hernia (1%), Meconium illeus(1%), Meconium plug syndrome (1%) were other causes. 61 cases were due to acquired causes while the rest were congenital causes. Also small bowel obstruction was more common than large bowel obstruction (65% as compared to 35%). Postoperative complications were seen in 39% cases with wound infection (17%) and wound dehiscence (9%) being the commonest. The mean hospital stay was 10.25 days (SD=5.14) , which was affected significantly by malnutrition (p=0.00027) and delayed presentation (p=0.018). Mortality rate was 6% with overwhelming sepsis (66%) and multiple congenital anomalies (33.33%) being the commonest causes. Mortality was more in neonatal group (83.33%). Conclusions: With improving health care, while mortality as an outcome of management is low, the morbidity is still on higher side in pediatric obstruction cases. Neonatal age, malnutrition and low birth weight in neonates, delay in presentation and delayed referral from primary health centers and general practitioners adversely affects the morbidity.
Authors and Affiliations
Shivprasad Hirugade, Harish N Patil, Amit Chopade, Shilpa S Hirugade
Keywords
Related Articles
- EP ID EP498624
- DOI -
- Views 82
- Downloads 0
Nanoparticles coupled with microorganisms mediated photocatalytic mineralization, detoxification and disinfection of phenolic waste water
Solarphotocatalysis is an important aspect of AOPs for the treatment of organic pollutants in industrial wastewater. The photocatalytic activity of Zinc Oxide nanoparticles also prove to be an efficient method for degrad...
Effect of Meditation on Lipid Profile of Postmenopausal Women
Introduction: In order to contribute to the better understanding of effect of meditation in postmenopausal women, the present study was conducted to estimate the serum levels of total cholesterol (TC), triglyceride (TG),...
Evaluation of LH, FSH and Testosterone in Infertile Males
Infertility is defined as the inability of a couple to conceive after at least 12 months of unprotected sexual intercourse. The failure of pituitary to secret FSH and LH will result in disruption of testicular function l...
A clinical study of effect of transcutaneous nerve stimulation (TENS) in labour analgesia
Objective: Objectives are to observe the onset, effectiveness, extent of labour analgesia using TENS and cardiovascular and respiratory changes in mother. Effect of TENS on the progress of labour on fetal heart rate and...
Infantile Spasms–A Clinical and Follow up Study
Infantile spasms (IS; West syndrome) is a severe form of encephalopathy that typically affects infants younger than 2 years old. Information about infantile spasms in Indian literature is very sparse. Educating pediatric...