SURGICAL INTESTINAL OBSTRUCTION IN THE NEWBORN: AETIOLOGY AND MANAGEMENT

*Ammar Youssef and Wajih Ali

ABSTRACT

Background: Intestinal obstruction is the most common surgical emergency in neonates requiring admission to the neonatal intensive care unit (NICU). Given its diverse causes, including intestinal atresia, congenital anomalies, and surgical complications, prompt diagnosis and appropriate management are crucial to improving survival rates and reducing morbidity in affected neonates. Objective: To identify the patterns of neonatal intestinal obstruction and the appropriate surgical management. Materials and Methods: A retrospective study included all neonates admitted to the Neonatal Intensive Care Unit (NIU) at Tishreen University Hospital between 2017 and 2022 who were diagnosed with intestinal obstruction and underwent surgical repair. Detailed information was obtained from neonates' records (gestational age, age at diagnosis, weight, sex, presence of associated lesions), as well as information on clinical signs and symptoms suggestive of intestinal obstruction, the surgical procedure performed and time of intervention, and the final diagnosis causing the obstruction. Results: The study sample included 48 neonates, most of whom were full-term (70.8%). The mean gestational age was 37 weeks, with a mean birth weight of 2664 grams. The mean age at diagnosis and surgical intervention was 7.6 days. It is worth noting that (56.3%) of the sample had concomitant malformations, the most common of which were cardiac malformations (50%). The most frequent clinical sign was Failure to pass meconium (93.8%), while other symptoms and signs were less common. Surgical procedures varied, with intestinal stoma being the most common (58.3%). The final diagnoses included 12 congenital malformations, with anal atresia accounting for the highest percentage (41.7%), followed by malrotation (14.6%). Conclusion: Emphasizing the need to follow up on any digestive symptoms that the newborn suffers from by the parents, pediatricians, and pediatric surgeons to help in early detection of any abnormalities to manage them at the most appropriate time.

Keywords: Surgical Intestinal Obstruction - Newborn – Aetiology – Management.