Intestinal Atresia: A Four-Year Review of Cases in Ikeja-Lagos.

Introduction: Intestinal atresia is one of the most common causes of neonatal intestinal obstruction worldwide. The pattern of presentation and management in our institution is reviewed. The objective of the study was to evaluate the pattern of intestinal atresias and stenoses in newborns who presented to our unit. Materials and Methods: A retrospective study of patients with intestinal atresias and stenoses who presented between September 2004 and November 2008. The clinical presentation, diagnoses, operative management, post operative care and outcome were obtained from the case notes. Results: Thirty cases were seen in that period, M:F; 1:1.5. Eleven (36.7%) were duodenal pathologies and 19 (63.3%) were jejunoileal. The main presenting symptom was bilious vomiting. Overall mortality is 40.9%. Prematurity and delayed presentations are the major contributing factors to mortality. Conclusion: Improvement of health care facilities as well as public health education to seek early intervention will improve outcome. Maternal awareness of this condition would lead to prompt seeking of treatment for paediatric patients.

Apple Peel Small Bowel, A Review of Four Cases Surgical and Radiographic Aspects.

Background: Although apple peel intestinal atresia is rare and is associated with a high mortality and morbidity, there is a dearth of its report in African literature. This study reviews four of the cases seen in a state teaching hospital in Lagos, considering the radiographic findings, surgical management and outcome. A brief review of literature is also undertaken. Aims and Objectives: To correle the plain radiographic findings with the surgical findings of neonates gathered over a six year period and to evaluate their surgical management, hoping to further help improve management of such neonates’ in future in resource limited regions such as ours. Methodology: It was a retrospective case series of four neonates who were brought in over a period of six years and operated after an initial plain abdominal X-ray. They were done as emergency cases, consent was obtained from their parents and the study was approved by the research and ethics committee. Operative findings were subsequently correlated with their radiographic findings and the surgical outcomes and follow up were documented. Conclusion: This study revealed that “the triple bubble sign” is a common radiographic finding in Apple Peel deformities, as well as gangrene of the jejunum and ileum at surgery.