Patterns and Surgical Outcome of Pediatric Intestinal Obstruction in Pakistan

Chaudhry, Ali Raza; Nisar, Muhammad Umar; Khan, Anwar Hossain; Akhtar, Nadeem; Sikander, Samer; Khan, Nisar

doi:10.52206/jsmc.2021.11.1.39-44

Cited by 3 publications

(2 citation statements)

References 7 publications

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“…2,6 The gastrointestinal conditions were the most common neonatal surgical conditions noticed in our study and anorectal malformations were the commonest (40/86%) followed by necrotizing enterocolitis (10.57%) and Hirschsprung's disease (9.6%), resembling figures are reported in the literature by Saha and Ekwunife. 2,9 Data published by Ali Raza and others 10 show a higher percentage of cases of Duodenal atresia as compared to our study but their figures for Hirschsprung's disease are nearly similar, however, in the present study, the number of patients with necrotizing enterocolitis were on the higher side in comparison to above-mentioned study.…”

Section: Discussioncontrasting

confidence: 53%

“…In spite of working in low-resource centers with scares facilities, the complication rates were on the lower side in the present study as compared with published literature. 9,10,12 Out of 208 patients, 180 (86.53%), patients improved and were discharged home while only 4 (1.92%) patients with esophageal atresia were referred to other centers due to the nonavailability of ventilators. During the study period 24 (11.53%), neonates expired.…”

Section: Discussionmentioning

confidence: 99%

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The Outcome of Different Surgical Conditions in Neonates at A Tertiary Care Hospital: A Cross-Sectional Study

Mahtam¹,

Soomro²,

Sumaira³

2022

PJMHS

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Aim: To determine the outcome of different surgical conditions in neonates at a tertiary care hospital Study design: A cross-sectional study Place and Duration: Department of Pediatric Surgery Chandka Medical College Children’s hospital Larkana from Nov 2020 to Nov 2021 Methodology: All the neonates with surgical conditions were admitted through emergency and OPD. The variables were age, gender, diagnosis, surgery performed, postoperative course and complications if any. Patients soon after birth to 28 days of age with neonatal surgical conditions were enrolled in the study. The diagnosis was established either with pre-operative, intra-operative or post-operatively with relevant clinical, radiological, biochemical and histopathological findings described in standard textbooks of paediatric and neonatal surgery Results: A total of 208 patients were managed. The age range was 1 hour to 28 days. Male was 159 (76.4%) and 49 (23.6%) were female. The commonest conditions presented were anorectal malformations followed by necrotizing enterocolitis. Other conditions include Hirschsprung’s Disease, Omphalocele, Gastroschisis, Duodenal and Jejuno ileal Atresia, Myelomeningocele, Infantile Hypertrophic Pyloric Stenosis, Obstructed Inguinal Hernias, sacrococcygeal teratoma and skin and soft tissue infections. Frequently performed operation was the creation of stoma (Colostomy/Ileostomy). 180 (86.53%) neonates were discharged and 24 (11.53%) neonates expired while only 4 (1.92%) neonates were referred to other centers. Conclusion: Neonatal surgical conditions carry high mortality and morbidity even at centers with all facilities available. Our results at the resource-limited centre are comparable to the centres having state of art facilities. Keywords: Neonatal surgery, Anorectal Malformations, Abdominal wall defects, Necrotizing Enterocolitis (NEC)

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Section: Discussioncontrasting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

The Outcome of Different Surgical Conditions in Neonates at A Tertiary Care Hospital: A Cross-Sectional Study

Mahtam¹,

Soomro²,

Sumaira³

2022

PJMHS

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Jejunoileal atresia: a case-series of 63 neonates and risk factors to mortality

Saleem¹,

Liaqat

Butt³

et al. 2022

Ann Pediatr Surg

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Introduction Jejunoileal atresia (JIA) among neonates is still a condition which has huge morbidity and mortality, particularly in the developing world. We share a case series of JIA in context of their presentation, management, and outcome. Materials and methods This study was conducted at Children’s Hospital and Institute of Child Health, Lahore, over 1 year. We included all patients presenting with JIA, and their demographic details, presentation, investigations, treatment strategies, and the outcome were noted at a pre-designed proforma. All data were analyzed using SPSS version 26. Results A total of 63 neonates with JIA were included. Most of them (79.4%) presented after 48 h of life, and the mean age at presentation was 5.68 ± 4.75 days. There were 37 male patients (58.7%), and 51 (81%) were full-term. The most common presenting complaint was not being able to pass meconium (88.9%). Type III atresia was the most common subtype (41.3%). Most of them underwent resection without tapering. The mean hospital stay was 12.81 ± 6.53, and it was significantly longer among those who underwent re-exploration (P = 0.034). Twenty-three patients (36.5%) expired within 6 months of follow-up. The only significant factor for mortality was the presence of short bowel syndrome (P = 0.030). All other demographic and management factors did not alter the mortality rate. Conclusion Management of surgical neonates is a difficult job in developing countries with limited resources. There is a high mortality rate of neonates following JIA surgeries, and surgeons in these countries must fight on many fronts to improve the outcome.

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Endosurgical technologies in the treatment of children with intestinal obstruction

Korovin,

Dzyadchik,

Donskoy

et al. 2024

Medicinskij sovet

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Introduction. In recent years there has been an increase in the number of cases of postoperative adhesive intestinal obstruction among children after surgical interventions due to congenital anomalies of the gastrointestinal tract, traumatic injuries and abdominal masses. The laparoscopic technology opportunities are directly related to the type of obstruction and the severity of the patients’ condition on admission. The rationale for laparoscopic technologies will help improve the outcomes of surgical treatment of children with various types of intestinal obstruction.Aim. To evaluate the effectiveness of laparoscopic technologies in a group of children with intestinal obstruction.Materials and methods. The study included 88 patients who underwent surgery for intestinal obstruction from 2008 to 2022 at the age of 1 month up to 18 years (7.75 ± 4.62). The patients were divided into two groups: Group I – obstructive intestinal obstruction (51) and Group II – strangulating intestinal obstruction (37). Methods for personalized evaluation of the options for endosurgical interventions were created based on the coefficients of the Bayesian decision rule characteristics.Results and discussion. The method for personalized evaluation of the options for endosurgical intervention completion in the form of laparoscopic version was proposed on the basis of the analysis of clinical and anamnestic data, outcomes of instrumental approaches to preoperative diagnosis and laparoscopy in a group of patients with intestinal obstruction. Laparoscopic technology has proved to be effective in the groups of patients with obstructive and strangulation intestinal obstruction in 70 and 62.2% of follow-ups, respectively.Conclusion. The effectiveness of laparoscopic technologies in children with intestinal obstruction depends on the patients’ group-specific decision rule characteristics of the method for personalized evaluation of the options for endosurgical interventions and accounts for 66% (Sn – 90%; Se – 85%; ACC – 85.8%). The method for personalized evaluation of the options for endosurgical interventions is a highly informative test for a group of patients with intestinal obstruction (AUC – 92.2%).

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Patterns and Surgical Outcome of Pediatric Intestinal Obstruction in Pakistan

Cited by 3 publications

References 7 publications

The Outcome of Different Surgical Conditions in Neonates at A Tertiary Care Hospital: A Cross-Sectional Study

The Outcome of Different Surgical Conditions in Neonates at A Tertiary Care Hospital: A Cross-Sectional Study

Jejunoileal atresia: a case-series of 63 neonates and risk factors to mortality

Endosurgical technologies in the treatment of children with intestinal obstruction

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