A prospective study of intestinal obstruction in paediatric age group

Abstract

Background: Intestinal obstruction can occur at any age in the paediatric population1-4. Bowel obstruction in children differs from that in adults in terms of etiology, presentation and even the management. The aim of the study was to find out various etiologies, clinical features, outcome and mortality of paediatric age groups with intestinal obstruction and their relation to age and sex distribution.Methods: This is a prospective study of 50 cases of paediatric age group with signs and symptoms of intestinal obstruction which were admitted in Sir Sayajirao Gaekwad Hospital, Vadodara, India during period of December 2004 to November 2006. Surgical intervention was carried out where indicated otherwise patients were managed conservatively. Data was analysed in SPSS version 10 statistical software for percentage and frequencies.Results: Total 50 patients were included in the study. Among these 30 were males and 20 were females with M: F ratio of 3:2. Majority of them were 25 neonates of age group of 1-7 days (50%), followed by 7 infants of 1 months- 1 years (14%) and 18 children aged 1 years-12 years (36%).  Out of 50 patients, 41 (82%) patients had congenital causes in which 21(42%) patients had imperforate anus followed by Hirschprung’s disease in 8(16%), Meckel’s diverticulum in 6(12%), jejunal atresia in 4(8%), hypertrophic pyloric stenosis in 2 patients (4%) and 9(18%) patients had acquired causes in which intussusception was in 5(10%) patients, abdominal tuberculosis in 2(4%) and gangrenous appendix in 2(4%) patients. Total mortality was 6 out of 25 neonates and there were no mortality in infants and children groups.Conclusions: Majority of patients were neonates than infants and children with slight male preponderance with male: female ratio of 3:2. Congenital causes of intestinal obstruction were more common (82%) than the acquired causes (18%). Postoperative septicaemia was more common and overall mortality was exclusively in neonates.