Intestinal obstruction in southeastern Nigerian children

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Epidemiology

Background:

• Acute intestinal obstruction is a significant cause of pediatric morbidity and mortality globally.
• The etiological patterns of pediatric intestinal obstruction vary geographically.
• Limited data exists on the specific causes and outcomes of intestinal obstruction in Nigerian children.

Purpose of the Study:

• To retrospectively analyze the causes, patterns, and outcomes of acute intestinal obstruction in pediatric patients.
• To compare the epidemiological profile of pediatric intestinal obstruction in Nigeria with international data.
• To identify areas for improvement in the management of pediatric intestinal obstruction.

Main Methods:

• Retrospective review of 295 pediatric cases of acute intestinal obstruction.
• Data collected over a 10-year period (1981-1990) at the University of Calabar Teaching Hospital, Nigeria.
• Analysis of etiological factors, age distribution, anatomical location, and mortality.

Main Results:

• Ascaris worms (25%) and intussusception (22%) were the leading causes of obstruction.
• Other significant causes included imperforate anus (11%), volvulus (10%), external hernias (9%), and adhesions (7%).
• Mortality rate was 13%, primarily due to infection and management challenges.

Conclusions:

• The pattern of pediatric intestinal obstruction in this Nigerian cohort differs significantly from Western data.
• Ascaris-induced and hernial obstructions were more common in older children, while intussusception peaked in infants.
• Establishment of a dedicated pediatric surgical unit is recommended to improve outcomes.