Acute Intestinal Obstruction in Children: Experience in a Tertiary Care Hospital

Acute Intestinal Obstruction is one of the commonest surgical emergencies in children. These cases are invariably operated upon by general surgeons as pediatric surgeons are very few in Nepal. Outcome to a great extent depends on prompt clinical diagnosis and treatment. This is prospective study of 51 cases of intestinal obstruction admitted, operated and treated at Manipal Teaching Hospital, a tertiary care hospital in the Western Region of Nepal from January 2011 to September 2015. Aim of the study was to observe the pattern of intestinal obstruction in children and the treatment outcome in the hands of general surgeons. Number of cases in the cohort was 51. Out of that 50 cases were operated upon and 1 case was managed conservatively. Age of the patients’ ranged from 1 day to15 years (median age 9 months); There were 33 males and 18 females with a ratio of 1.8:1. Causes of intestinal obstruction were Intussusceptions (33), Meckel’s diverticulum (6), obstructed /strangulated hernia(4), imperforate anus(2), Hirschprung’s disease(2), Meconium ileus (1), Ladd’s band with malrotation of mid gut (1),annular pancreas(1) and Adhesions (1) Base line investigations of CBC, BT, CT, PT and serum electrolytes were done in all the cases. Plain x-ray abdomen erect and supine, ultrasonography (USG) and computed tomography (CT) scan were done in most of the cases and. Contrast study using Diatrizoate Meglumine (Gastrografin) was done wherever necessary. There were 3 mortalities and 2 cases had postoperative complications. Average post operative Hospital stay was 6 days. Early diagnosis and surgical intervention gives favorable outcome, delay increases morbidity and mortality. All these cases were taken up by general surgeons and the results were encouraging and good.