Intestinal obstruction in children

ABSTRACT

To identify various causes and the outcome of intestinal obstruction in children older than one month of age. Descriptive case series. Department of Paediatric Surgery Chandka Medical College Hospital Larkana, from January 2010 to December 2011. Patients above one month of age who presented with signs and symptoms of intestinal obstruction were included. Patients with history of chronic constipation, trauma, post diarroheal distention, obstruction resulting from compression by tumors. Those with free gas on x-ray abdomen and where management done conservatively were excluded from the study. During the study period a total of 55 cases, 41[74.5%] males and 14 [25.5%] females were operated. The age of patients ranged from 1 month to 14 year. The main presenting features were not passing stools [100%], pain abdomen [89.09%], vomiting [85.45%], abdominal distension [81.81%], fever [21.81%], bleeding per rectum [18.18%] and mass abdomen [16.36%]. The causes of intestinal obstruction found were intussusception [27.3%], Meckel's diverticulum with band causing obstruction [16.4%], obstructed inguinal hernia [14.5%], post operative adhesions [9.1%], congenital peritoneal bands [7.3%], Hirschsprung's disease [7.3%], abdominal tuberculosis [5.5%], typhoid ileal perforation [5.5%], malrotation [3.6%] and umbilical hernia [3.6%]. Fifty-four [98.18%] patients recovered and discharged while one [1.81%] patient died. Intussusception and Meckel's diverticulum with a band were the most frequent causes of intestinal obstruction. One patient in this series died.