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Published on: July 28, 2023
Clinical profile of neonatal intestinal obstruction in northeastern Nigeria
Samuel Wabada1, Adewale Olaotan Oyinloye2, Auwal Mohammed Abubakar2
1Department of Surgery, Paediatric Surgery Unit, University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria.
Introduction:
outcome of emergency neonatal surgery is still poor in developing countries due to a lack of trained workforce, cultural barriers, and poor understanding of the patient´s physiology. Aim: the focus of this study is to review the etiology and determine factors associated with poor outcomes of neonatal intestinal obstruction in northeastern Nigeria.
Methods:
a retrospective study of neonates aged 28 days at two tertiary Hospitals, the University of Maiduguri Teaching Hospital and Federal Medical Centre Yola was undertaken from February 2015-January 2020. Information on patients´ clinical features, duration of symptoms, diagnosis, treatment, and outcome were analyzed. Relationship between continuous and outcome variables was analyzed using ANOVA test, P-value < 0.05 is regarded as significant, confidence interval (CI) of 95%, while the correlation between categorical variables was analyzed with the Chi-square test.
Results:
the study had 147 (74.6%) boys and 50 (25.4%) girls (a boy-to-girl ratio of 2.9: 1). The mean weight of the cohort was 2.66±06 Kg. The most common causes of neonatal intestinal obstruction were anorectal malformations in 101 (51.3%), followed by intestinal atresias in 44 (22.3%), intestinal malrotations in 20 (10.2%), and Hirschsprung´s disease in 18 (9.1%). Most 124 (62.9%) neonates presented by the 5th day of life were severely dehydrated and hypothermic with signs and symptoms of intestinal obstruction. Severe dehydration and hypothermia fever were associated with high post-operative mortality in these categories of neonates presenting late. Hence, neonates with prolonged duration of symptoms statistically correlate with high post-operative mortality P< .002, CI: 6.81-8.49.
Conclusion:
anorectal malformations, intestinal atresia, and intestinal malrotation are common causes of neonatal intestinal obstruction in Nigeria.
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