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Intestinal obstruction in neonates: causes of death
Insights
Infectious complications are the primary cause of death in pediatric intestinal obstruction surgery. Despite overall mortality reduction, newborn mortality from this condition remains a concern.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Infectious Diseases
Background:
- Intestinal obstruction in children poses significant mortality risks.
- Infectious complications like peritonitis, septicaemia, and pneumonia are leading causes of postoperative death.
- Previous studies highlight the critical impact of infections on surgical outcomes.
Purpose of the Study:
- To analyze the causes of death in pediatric intestinal obstruction.
- To evaluate the trends in mortality rates for intestinal obstruction in children.
- To identify persistent challenges in managing neonatal intestinal obstruction.
Main Methods:
- Retrospective analysis of 237 pediatric patients with intestinal obstruction.
- Review of national mortality data in Germany (1967-1976) for pediatric intestinal obstruction.
- Comparison of mortality trends across different age groups (infancy, childhood, newborn).
Main Results:
- Infection accounted for 85.7% of deaths in a series of 237 pediatric intestinal obstruction cases.
- While overall pediatric intestinal obstruction mortality decreased, neonatal mortality showed a slower decline.
- The relative mortality rate for intestinal obstruction in newborns has remained constant at approximately 20% over the past two decades.
Conclusions:
- Infectious complications remain the most critical factor in pediatric intestinal obstruction mortality.
- The declining birth rate may influence overall pediatric mortality statistics for intestinal obstruction.
- Neonatal intestinal obstruction continues to present a significant and persistent mortality challenge requiring focused interventions.
Abstract:
Infectious complications such a peritonitis, septicaemia and pneumonia are the most important factors causing postoperative death in surgery of intestinal obstruction in children. In a series of 237 patients with intestinal obstruction with 21 fatalities, the percentage of deaths due to infection was 85.7%. In 1967 to 1976, 259.301 children died in Germany, among them 1541 suffering from intestinal obstruction (0.6%); that means 3.1% of the 49.540 patients who died of intestinal obstruction were children. The mortality of intestinal obstruction in infancy and childhood had fallen to one third of the original during this period, but the mortality in newborn infants fell only by 50%. This correlates with the decreasing birth rate, so that the lower death rate due to intestinal obstruction seems to be explained by a lower number of neonates. The literature shows that relative mortality (20%) from intestinal obstruction in the newborn has, however, remained constant during the last 20 years.