The intestinal intussusception as a cause of bowel obstruction in adult is a rare finding and is a heralder for an underlying lesion. This is in stark contrast to intestinal intussusception in pediatric population where the etiology is always a primary or benign condition and thus bears different outcomes. We hereby present a case of a young female adult, without the presence of any significant comorbidity. She presented with nonspecific symptoms of small bowel intussusception. She was diagnosed as a case of adult intussusception with abdominal ultrasonography. The patient underwent complete resection of the tumor, without any reduction attempts, as the best plausible therapeutic approach. Further, in post-operative evaluation, complete pathological analysis of the resected specimen divulged the presence of inflammatory myofibroblastic tumor (IMT) as the underlying lead point of mid-ileo-ileal intussusception.
BackgroundAnorectal malformations are congenital defects wherein there is defective development of the anus and rectum. For babies born with congenital anorectal malformations, prompt treatment is crucial which requires detection of the anomalies at the earliest. This study aimed to determine the epidemiology of anorectal malformations in the Pediatric Unit of a tertiary care hospital in Pakistan over a period of 19 months.
MethodologyAn analytical cross-sectional study was conducted retrospectively from January 2020 to September 2021 using a non-randomized consecutive sampling technique. Patients aged less than eight years were included, whereas burnt, torn, and incomplete records from the Hospital Management Information System (HMIS) were excluded. SPSS version 26 (IBM Corp., Armonk, NY, USA) was used for data entry and analysis. Binomial and multinomial logistic regression were applied for analyzing the association between explanatory and dependent variables.
ResultsOf the 1,108 patients, 72 (6.5%) patients had anorectal malformations. Gastrointestinal diseases made up about 64.3% of all diseases. Among gastrointestinal causes, the prevalence of anorectal malformation was up to 10.1%. The mortality of anorectal malformation patients was low (2.85%) compared to mortalities due to other gastrointestinal abnormalities (8.25%). Anorectal malformation had significantly lower odds of mortality (adjusted odds ratio = 0.19, p < 0.05) compared to other gastrointestinal abnormalities.
ConclusionsThis study has provided data about the prevalence of anorectal malformation and its mortality which were calculated as 6.5% and 2.58%, respectively. Female gender, neonates, and delayed presentation were seen to have higher mortality, highlighting the need to screen all neonates pre-and post-natally to avoid any misdiagnosis.
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