K. Ravi, Dr. Mohamed Zaheer


INTRODUCTION: Intestinal obstruction is one of the commonest diagnosis on admission in newborn surgical unit.
Intestinal obstruction is still a challenging and commonly encountered acute condition in paediatric surgical practice
and it is more difficult in the management in newborn age group. Early diagnosis and treatment is more important
because delay in management may lead to mortality and morbidity. The common causes are congenital malformation
like atresia of small and large intestine, duplication cyst, congenital pyloric stenosis, malrotation, Hirshsprung's disease,
meconeum ileus, congenital bands, Anorectal malformations etc.
AIM OF THE STUDY: To evaluate various aetiologies of neonatal intestinal obstruction, clinical presentations,
associated anomalies, surgical techniques and its duration employed in the management and to identify the high risk
factors contributing to the morbidity and mortality in newborn intestinal obstruction.
MATERIAL AND METHODS: This retrospective study conducted at Raja Mirasdhar Hospital attached with Thanjavur
Medical College, Thanjavur from January 2017 to December 2019 evaluating the prognostic factors in neonatal
obstruction. The Study identified 48 cases of newborns with intestinal obstruction those who have undergone
laparotomies during the study period. Neonates less than 28 days were included in this study with history of abdominal
distension, vomiting, failure to pass meconium etc. Newborns more than 28 days and diseases such as Esophageal
Atresia, Hirschsprung's disease and Anorectal malformation were excluded from our study.
OBSERVATION: A total of 48 cases evaluated during the period of study. The following data were collected from the
case sheets of for evaluation. Demographics like age, sex and weight of the newborn baby was recorded. Special care
was taken to identify antenatal history of polyhydramnios and maternal diabetes. Antenatal ultrasonogram if available is
taken into consideration. Presence of associated congenital malformation at birth if any was recorded. The general
condition of the newborn on admission, presence of dehydration, sepsis and hypothermia were noted. The clinical
presentation on admission and any associated conditions like prematurity, jaundice and electrolyte imbalance were
recorded. Routine and specific investigations were done for the diagnosis of various aetiology of intestinal obstruction.
Surgical technique employed and duration of surgery was noted. Postoperative course of the case and the complications
were recorded. The length of the hospital stay of the newborn baby was recorded.
CONCLUSION: The commonest cause of neonatal intestinal obstruction was jejunoileal atresia presenting as bilious
vomiting and abdominal distension. The commonest associated condition in neonatal intestinal obstruction is
malrotation, prematurity and congenital heart disease. Surgical outcome depended on complexity of the disease and
duration of surgery. Low birth weight, prematurity, congenital heart disease and sepsis are high factors for morbidity and
mortality in neonatal intestinal obstruction.


neonatal, intestinal, obstruction

Full Text:



Sumit Dave , D.K Gupta: Neonatal Intestinal Obstruction. D.K.Gupta (1st Ed).

Textbook of Neonatal Surgery, Modern, 2000, 150-54.

Marshall Z. Schwartz: Hypertrophic pyloric stenosis. Jay L.Grosfeld, James A.

O Neill, Arnold G.Coran et al. Pediatric Surgery (6th edn). Mosby, 2006, 1218.

Samuel D.Smith : Disorders of Intestinal rotation and fixation. Jay L.Grosfeld,

James A. O Neill, Arnold G.Coran et al. Pediatric Surgery (6th edn). Mosby,

, 1352.

George B. Mychaliska: Introduction to neonatal intestinal obstruction. Oldham,

Keith T; Colombani Principles and Practice of Pediatric Surgery, 4th Edition.

Lippincott Williams & Wilkins, 2005 , 1222

Reyes HM, Meller JL, Loeff D. Neonatal intestinal obstruction. Clin Perinatol

;16(1):85 – 96.

Sumit Dave ,D.K. Gupta : Duodenal atresia and stenosis .D.K.Gupta

Textbook of Neonatal Surgery (1st Ed) , Modern, 2000,172-79 .

Arnold G.Coran et al. Pediatric Surgery (6th edn). Mosby, 2006, 89.

Santulli TV. Intestinal obstruction in the newborn infant. J Pediatr 1954;44:317-

Dalla Vecchia LK, Grosfeld JL, West KW, et al. Intestinal atresia and stenosis: a

-year experience with 277 cases. Arch Surg 1998;133(5):490- 496; discussion

- 97.

Bailey PV, Tracy TF Jr, Connors RH, et al. Congenital duodenal obstruction: a

-year review. J Pediatr Surg 1993;28(1):92 -95.

Hancock BJ, Wiseman NE. Congenital duodenal obstruction: the impact of an

antenatal diagnosis. J Pediatr Surg 1989;24(10):1027-31.

Harberg FJ, Pokorny WJ, Hahn H. Congenital duodenal obstruction. A review

of 65 cases. Am J Surg 1979;138(6):82528.

Ford EG, Senac MO Jr, Srikanth MS, et al. Malrotation of the intestine in

children. Ann Surg 1992;215(2):172-78.

Stewart DR, Colodny AL, Daggett WC. Malrotation of the bowel in infants and

children: a 15 year review. Surgery 1976;79(6):716 -720.

Torres AM, Ziegler MM. Malrotation of the intestine. World JSurg


Corteville JE, Gray DL, Langer JC. Bowel abnormalities in the fetus”a

correlation of prenatal ultrasonographic findings with outcome. Am J Obstetr

Gynecol 1996;175:724-29

Moore CC. Congenital gastric outlet obstruction. J Pediatr Surg


Farrant P, Dewbury KC, Meire HB. Antenatal diagnosis of duodenal atresia. B

J Radiol 1981; 54:633-35.

Kimble RM, Harding JE, Kolbe A. Does gut atresia cause polyhydramnios?

Pediatr Surg Int 1998;13:115 -17.

Agostino Pierro, Simon Eaton, Evelyn Ong: Neonatal physiology and

Metabolic considerations. James A. O Neill,

Grosfeld JL, Rescorla FJ. Duodenal atresia and stenosis: reassessment of

treatment and outcome based on antenatal diagnosis, pathologic variance, and

long-term follow-up. World J Surg 1993;17:301.

Adeyemi D. Neonatal intestinal obstruction in a developing tropical country:

Patterns, problems and prognosis. J Trop Pediatr 1989;35:66-70.

Nyberg DA, Resta RG, Luthy DA, et al. Prenatal sonographic findings of

Down syndrome: review of 94 cases. Obstet Gynecol 1990;76:370.

Nixon H H, Tawes R: Etiology and treatment of small intestinal

atresia.analysis of a series of 127 jejunoileal atresias and comparison with 72

duodenal atresias. Surgery ;1971;69:41-51.


  • There are currently no refbacks.