Neonatal Intestinal Obstruction in Mosul City

Abstract

ABSTRACT:BACKGROUND:Intestinal obstruction is the most common surgical emergency of the newborn. Those cases require specialized care and facilities for survival. It may be caused by several embryonic and functional anomalies. we studied the causes of neonatal intestinal obstruction in mosul in the north of Iraq to get data that was not available about this subject.OBJECTIVE :To study the causes of neonatal intestinal obstruction and the pattern of their distribution in Mosul city and its drainage areas in the north of Iraq.METHODS:A prospective study of 156 cases with neonatal intestinal obstruction ,all of our patients were managed in Al-Khansa' teaching hospital in the period between( February 2001-2003).RESULTS:The male:female ratio was 1.9:1. Mean duration of symptoms 4.33 days. The most common cause was imperforate anus(22.4%), followed by intestinal atresia (15.4%), meconium plug syndrome (13.5%), medical causes (12.2%), congenital megacolon (11.5%), neonatal perforation (4.5%), necrotizing enterocolitis (NEC) and simple meconium ileus (3.9%) malrotation (2.6%), respectively and other rare causes (< 2%). The overall mortality was 22.2%. the mean duration of hospital stay 5.4 days.CONCLUSION:The causes of neonatal intestinal obstruction and the percentage of each cause are in variance with other studies. Imperforate anus and functional causes (e.g. ileus, sepsis) were higher, while intestinal artesia , meconium ileus and malrotation were lower than recorded by others.The mortality is near to that in developing countries with higher mortality in cases of necrotizing enterocolitis, meconium ileus and other rare causesof obstruction; delayed presentation and the lack of neonatal intensive care units at the time of the study being the main problems, that resulting in high mortality rate