Neonatal surgical emergencies in Iraq

ABSTRACT

Neonatal surgical emergencies [NSEs] yield deep concerns the aim of this study is to the families, pediatricians, and pediatric surgeons to identify the magnitude and pattern of neonatal surgical emergencies in Iraq. We studied the medical records of neonatal surgical emergencies admitted to the Department of Pediatric Surgery/Children's Welfare Hospital/Baghdad during the period of 1st January to 31st December 2006. The collected data involved clinical presentation, operative diagnosis, postoperative complications, duration of hospital stay, and final outcome. Data were addressed as percentages. Out of 310 total pediatric surgical emergencies admitted during the study period, 135 [43.5%] were neonates. Males were 57.8% and 42.2% females with a male to female ratio of 1.41. Predominance of cases was represented by tracheo-esophageal fistula/atresia [28.8%], imperforated anus/rectovesical or rectovaginal fistula [22.2%], and pyloric stenosis [10.4%]. Intestinal obstruction was the leading clinical presentation [58.5%] followed by shortness of breath and frothy mouth secretions during feeding [33.3%], visible abdominal mass [6.6%], and acute abdomen [1.4%]. Postoperative complications occurred in 56.3% of neonates as pneumonia [31.6%], sepsis [24.8%], and respiratory failure [23.7%]. Operative mortality was 30.4% due to respiratory failure [48.7%], overwhelming sepsis [43.7%] and cardiac arrest during anesthesia [7.3%]. Neonatal surgical emergencies represented a significant health threat and were characterized by high morbidity and mortality. Departments of pediatric surgery must receive ample support to properly deal with these emergencies