Intestinal Atresia: A Four-Year Review of Cases in Ikeja-Lagos

Abstract

Introduction: Intestinal atresia is one of the most common causes of neonatal intestinal obstruction worldwide. The pattern of presentation and management in our institution is reviewed. The objective of the study was to evaluate the pattern of intestinal atresias and stenoses in newborns who presented to our unit. Materials and Methods: A retrospective study of patients with intestinal atresias and stenoses who presented between September 2004 and November 2008. The clinical presentation, diagnoses, operative management, post operative care and outcome were obtained from the case notes. Results: Thirty cases were seen in that period, M:F; 1:1.5. Eleven (36.7%) were duodenal pathologies and 19 (63.3%) were jejunoileal. The main presenting symptom was bilious vomiting. Overall mortality is 40.9%. Prematurity and delayed presentations are the major contributing factors to mortality. Conclusion: Improvement of health care facilities as well as public health education to seek early intervention will improve outcome. Maternal awareness of this condition would lead to prompt seeking of treatment for paediatric patients.

Presentation and outcome of treatment of jejunoileal atresia in Nigeria

“…Jejunoileal atresia in our setting is associated with delayed presentation as in the present report with 63.2% presenting after the second day of life; however, this presentation appears to be slightly earlier than in a previous report from the same center. [3] Other series reported average age of presentation between 3 and 10 days,[12345111213] and a prospective study observed that a high number of patients presented early. [12]…”

“…[14] In many developing countries, prenatal diagnosis is uncommon. [101213] This could be due to the steep learning curve and/or poor resolution ultrasound machines. However, a study in Enugu reported that 56% of their patients had a prenatal diagnosis of intestinal atresia out of those who had antenatal sonography.…”

“…Congenital anomalies associated with jejunoileal atresia is less common than observed with duodenal atresia;[113] intestinal atresia in patients with gastroschisis is well documented. [121517] Nearly 15.8% of patients in this study had associated congenital anomalies.…”

“…TPN and neonatal ventilation are not readily available in a resource-limited setting like ours,[591013] which have been shown to improve outcome. [19] Patients were given intravenous dextrose, amino acids (Astymin ® ), and microelements, but lipids are not readily available, and when available, it is in adult packaging and quite expensive.…”

“…[51519] However, in developing counties, the mortality is still regrettably high due to the limitation of required highly trained neonatal care personnel, neonatal anesthetist, and neonatal intensive services. [123459101213]…”