Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
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Intestinal Atresia: Demographic Characteristics, Presentation, Management, Complications and Outcomes after Surgical Intervention in Tertiary Health Care Centre of Developing Country
Ravindra Sevar, Vinita Chaturvedi, Neeraj Tuteja and Atul Kumar Khare
Page: 438-444 | Received 20 Jun 2023, Published online: 04 Jul 2023
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Abstract
Intestinal atresia is one of the most common and leading causes of neonatal intestinal obstruction (NIO) and second most common cause of NIO in many developing countries. In this study, we noted to highlight the short‐term outcome of surgical management of intestinal atresia in our unit. This prospective and retrospective cohort study done in one‐year period from March 2021‐2022 in tertiary care hospital in Indian population (mainly West India). The main aims of our study are: “intestinal atresia: Demographic characteristics, presentation, management, complications and outcomes after surgical intervention in tertiary health care centre of developing country’’. All patient of intestinal atresia admitted in our centre in neonatal unit in one‐year period from March 2021‐2022, are data recorded and analysed. Data of demographics, antenatal history, presentation, location and type of IA (duodenal, jejuno‐ileal, colonic) and peri‐operative complications were recorded. After making our presumptive diagnosis, clinical assessment, an upright X‐ray abdomen was taken and Decision of surgery was taken . Statistical Package for Social Sciences (SPSS 15.0 version, SPSS Inc, Chicago Ill) was used for data entry and analysis. Results were expressed as means, ranges and percentages. Males are 64 and females are 48 patients, M/F ratio was 1.3:1. average weight of atresia is 2.14 kg (ranges from 1.1‐ 3.3 kg). mean age of presentation is 6.54 days (ranges from one day to 32 days). Patients have age more than one week only 28 (25%) patients found. Cases is highest in December and lowest cases in April month. Muslims population mostly associated with duodenal atresia. intestinal atresia included are duodenal atresia: (n = 44), Jejuno‐ileal: (n = 60), Colonic: (n = 4), Multiple atresia: (n = 4). In duodenal atresia DA‐ type‐1 (n = 14) in which annular pancreas (n = 6) and perforated duodenal web (n = 4), DA: type‐2 (n = 2) and DA‐type‐3 (n = 28) cases. In duodenal atresia, TEF associated with (n=3), ARM associated with (n = 3) and ARM with TEF both associated with (n = 2) cases. in jejunoileal atresia type‐1 (n = 10), Type‐2 (n = 5), Type‐3a (n = 36), Type‐3b (n = 1), Type‐4 (n = 12) are recorded. in colonic atresia type‐1 (n = 3), type‐2 (n = 0) and type‐3 (n = 1) cases are recorded. in DA vomiting is chief complain while in JIA and IA abdominal distension, bilious vomiting and failure to pass meconium is chief complains. All patients go to surgical repair. We surprising result found in jejunal atresia patient with tapering enteroplasty with trans‐anastomotic tube have 100% survival rates. Most common complication is functional obstruction followed by SSI and anastomotic leak. Mostly reoperation required in JIA cases. returning of bowel function is 4.3 days in DA, 6.2 days in JIA and 8.4 days in colonic atresia observed. mean hospital stay for DA is 11.4 days, for jejunal atresia 12.8 days and for CA 11.5 days for survivors. Overall survival rates of surgery of intestinal atresia after surgery is 51.8%. for DA 59.1%, jejunoileal atresia: 50% and for CA: 50%. one month follow up comes with mainly cough and cold n = 7 (6.25%), fever n = 5 (4.46%), functional obstruction n = 2 (1.78%) and with sepsis in n = 1 (0.9%) found. Short‐term survival of neonates with intestinal atresias in our unit is still poor when compared with statistics from developed countries. We trying to improve surgical outcomes in and understand difficulties faced by surgeons by this study.
How to cite this article:
Ravindra Sevar, Vinita Chaturvedi, Neeraj Tuteja and Atul Kumar Khare. Intestinal Atresia: Demographic Characteristics, Presentation, Management, Complications and
Outcomes after Surgical Intervention in Tertiary Health Care Centre of Developing Country.
DOI: https://doi.org/10.36478/10.59218/makrjms.2023.438.444
URL: https://www.makhillpublications.co/view-article/1815-9346/10.59218/makrjms.2023.438.444