Clinical and Statistical Study on the Congenital Anomalies of the Digestive system

ABSTRACT

A study was conducted to present clinical and statistical analysis of pediatric patients admitted to Severance Hospital between Jan. 1966 and Dec. 1975. Remakable progress has been made in the field of pediatrics and pediatric surgery, particularly in physiology, anesthesiology and operative technique. However, the ultimate result hasn't been totally satisfactory, largely due to the lack of cognizance of early diagnosis and prompt treatment. Futhermore, most of the patients with associated abnormal conditions, such as congenital heart disease, other associated G.I. anomalies and chromosomal anomalies, require surgery, urgently A total of 250 cases were analyzed according to systems. The following results were obtained; 1. 1. In the sex ratio male to female was 6-7:1. 2. 2. The order of frequency of diseases was as follows; Congenital megacolon 50 cases(20.0%), Imperforated anus 45 cases (18.0%), Congenital hypertrophic pyloric stenosis 41 cases(16.4%), Congenital anomalies of intestine 29 cases (11.6%), Congenital anomalies of hepatobiliary system 25 cases(10.0%), Meckel's diverticulum 18 cases(7.2%), Situs inversus 11 cases (4.4%), Congenital diaphragmatic hernia 6cases(2.4%), Congenital anomalies of cecum 6 cases(2.4%), Esophageal diverticulum 6 cases (2.4%), Esophagealatresia 4 cases (1.6%), Congenital anomalies of pancreas 4 cases (1.6%), Patent omphalomessentric duct 2 cases (0.8%), Congenital intestinal perforation 2 cases (0.8%), and Congenital stomach perforation 1 cases (0.4%). 3. There was an overall mortality rate of 36 cases (18.9%), the causes of death were frequently associated with respiratory failure. 4. Associated congenital anomlies were found in 57 cases. They were G. I. Anomalies, congenital heart diseases, Down's syndrome and cleft palate. 5. Of significance was the fact in this study, congenital megacolon had the highest incidence which was in sharp contrast to accidental series in which congenital hypertrophic pyloric stenosis showed the peak incidence. These figures are very similar to that reported in various publications. This analysis suggest that a more keen understanding of neonatal physiology, embryology, surgical technique and improved post-operative care for anomalous patients, may certainly improve the ultimate outcome of corrective surgery.