Pattern of intestinal obstruction in infants and children

ABSTRACT

To find out causes of intestinal obstruction in infants and children and their relation to age and sex distribution. This descriptive study was conducted at Peadiatric Surgery departments of Peoples University of Medical and Health Science for women Hospital Nawab Shah and Liaquat University of Medical and Health Sciences Hospital Jamshoro, from January 2010 to December 2010. All infants and children presenting with symptoms and signs of intestinal obstruction, and patients having advanced appendicitis with intestinal obstruction, were included in this study. Surgical intervention was carried out, where indicated, otherwise patients were managed conservatively. Patients were divided into two groups Infants were enlisted in group A, while toddlers and older children were put together in group B. Data was analyzed by using SPSS version 10 for percentage and frequencies Total 67 patients were included in the study. Among these 44 were Males and 23 Females with M F ratio of 1.91. There were 24 patients in group A, among these, 15[62.5%] cases had intussusception, while other conditions, namely incarcerated inguinal hernia, colonic web, post operative adhesions, ileal web and inflammatory bands constituted 37.5% cases of bowel obstruction. In group B there were 43 patients. These included, post operative adhesions in 6[13.95%] patients, while tuberculosis of intestine in 5[11.63%], Meckel's diverticulum with band 5[11.63%], perforated appendix in 5[11.63%], intussusception in 3[6.97%], Volvulus of small intestine in 3[6.97%] and Inflammatory bands and adhesions in 3[6.97%] patients. Malrotation, Hirschsprung's disease, Trichobezoar and faecal impaction each one occurred in 2[4.65%] patients. Ovarain teratoma, lymphoma, caecal Volvulus, duodenal web and duplication of colon of each one of these conditions occurred in one [0.43%] patient each. Resection of gut and anastomosis was carried out in 18[26.86%] patients [8 from group A and 10 from B]. Two patients from group B died. Pattern of intestinal obstruction varies at different age groups in terms of etiology as well as in relative incidence. Intussusception was the commonest cause in group A, while post operative adhesion had predominance in group B. Outcome depends upon the underlying condition and associated morbidity