Intestinal Obstruction in Early Neonatal Period A 3-Year Review Of Admitted Cases from a Tertiary Hospital in Ethiopia

Abstract

BACKGROUND: Failure to pass meconium by a full-termneonate within the first 24 hours should raise a suspicion of bowelobstruction. The objective of this study was to determine pattern ofpresentation, diagnosis and outcome of management of intestinalobstruction in the early neonatal period in the Neonatal Care Unitof Tikur Anbessa Specialized Hospital in Addis Ababa, EthiopiaMETHODS: Retrospective chart review of admitted cases fromJanuary 2011 to December 2013 was done. Data were entered intoSPSS software version 20. Descriptive analysis of data were done atfirst; then cross tabulation of variables with chi-square tests weredoneRESULT: Fifty-one (41 males and 10 females) cases of neonatalintestinal obstructions were described. ARM was the most commontype of intestinal obstruction followed by intestinal atresia andHirschsprung’s disease.Delayed diagnosis of cases was observed in 72%. Associatedcongenital anomalies were documented in 13 % of the cases. Deathoccurred in 20% of the cases. One or another form of infectionaccounted for 90% of the deaths. Neonatal sepsis and being unfitfor anesthesia were determinants of mortality with p-value <0.02and < 0.0007 respectively.CONCLUSION: Anorectal malformation is the commonest causeof early neonatal obstruction followed by small intestinal atresiaand Hirschsprung’s disease. Low number of associated anomalieshas been reported. High rate of death due to preventable causessuch as sepsis is observed. Delayed diagnosis of cases were alsoprevalent.