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Intestinal volvulus: an experience in a developing country
Insights
Pediatric volvulus surgery is complex, with high shock and resection rates. Despite a significant mortality rate, recent improvements in healthcare access have led to better survival outcomes for children.
Area of Science:
- Pediatric Surgery
- Gastrointestinal Surgery
- Surgical Outcomes
Background:
- Volvulus in children presents a significant surgical challenge.
- Many pediatric patients with volvulus present with severe symptoms like shock and dehydration.
- High rates of intestinal resection are often necessary.
Purpose of the Study:
- To analyze surgical outcomes for pediatric volvulus.
- To identify factors contributing to mortality in pediatric volvulus cases.
- To evaluate the impact of healthcare system improvements on survival rates.
Main Methods:
- Retrospective analysis of 82 children undergoing surgery for volvulus.
- Categorization of patients by age group (neonates, infants, children).
- Assessment of presenting symptoms, surgical interventions, and outcomes.
Main Results:
- A high incidence of shock (88%) and peritoneal signs (74%) was observed.
- The intestinal resection rate was 61%.
- Mortality rate was 38%, primarily due to septicemia, shock, and multiorgan failure.
Conclusions:
- Pediatric volvulus surgery is associated with substantial morbidity and mortality.
- Improvements in preventive health, transport, and referral systems are crucial for enhancing survival.
- Early diagnosis and intervention are vital for improving outcomes in pediatric volvulus.
Abstract:
Eighty-two children (47 boys and 35 girls) underwent surgery for a variety of causes resulting in volvulus. There were 20 neonates, 13 infants, 34 patients aged 1 to 5 years, and 15 children above 5 years of age. The majority (88%) of the patients were admitted in a state of shock and dehydration. Peritoneal signs were present in 74% of the patients. The resection rate was 61%. A high mortality rate of 38% was encountered, which was attributed to septicemia, shock, and multiorgan failure. The preventive health programs that are being actively implemented together with the improvements made in the transport and referral systems have fortunately resulted in much-improved survival rates in the recent few years.