Demographic Pattern, Management, and Outcome of Intestinal Atresias Among Neonates in a Tertiary Care Indian Hospital

Abstract

Objectives: To analyze the incidence, management approach, and outcome of intestinal atresias among neonates in our hospital. Design: Retrospective observational study. Settings: Tertiary care pediatric institute located in eastern part of India. Study period: January 2015 to December 2019. Results: Intestinal atresias constituted 54% of neonatal intestinal obstruction cases ( n = 369). Out of 201 cases of intestinal atresias, only 120 patients presented during first week of life and the male to female ratio was 1.3:1. The mean (±SD) weight at presentation was 2.03 (±0.49) kg and newborns below 1.5 kg were associated with significantly higher mortality ( P =.001). Jejunoileal atresias were found to be the most common type of atresia ( n = 116, 58%) followed by duodenal atresias ( n = 67, 33%). Colonic and pyloric atresias were found in 14 (7%) and 4 cases (2%), respectively. The overall mortality in the present study was 18% ( n = 36) and septicemia was the leading cause. Conclusion: Intestinal atresias were the most common cause of intestinal obstruction and surgical emergency in neonates. Although, there is gradual improvement in survival in these newborns, low birth weight, late presentation, and associated comorbidities are high risk factors. Increased awareness about these congenital anomalies, early referral to tertiary care centers, and timely management can improve the outcome.