African Journal of Paediatric Surgery About APSON | PAPSA  
Home About us Editorial Board Current issue Search Archives Ahead Of Print Subscribe Instructions Submission Contact Login 
Users Online: 280Print this page  Email this page Bookmark this page Small font size Default font size Increase font size 
 
ORIGINAL ARTICLE
Year : 2014  |  Volume : 11  |  Issue : 2  |  Page : 97-100

Indications and outcome of childhood preventable bowel resections in a developing country


Department of Surgery, Federal Medical Centre, Umuahia, Abia State, Nigeria

Correspondence Address:
Dr. Uchechukwu Obiora Ezomike
Department of Surgery, Federal Medical Centre, Umuahia, Abia State
Nigeria
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0189-6725.132783

Rights and Permissions

Background: While many bowel resections in developed countries are due to congenital anomalies, indications for bowel resections in developing countries are mainly from preventable causes. The aim of the following study was to assess the indications for, morbidity and mortality following preventable bowel resection in our centre. Patients and Methods: Retrospective analysis of all cases of bowel resection deemed preventable in children from birth to 18 years from June 2005 to June 2012. Results: There were 22 preventable bowel resections with an age range of 7 days to 17 years (median 6 months) and male:female ratio of 2.1:1. There were 2 neonates, 13 infants and 7 older children. The indications were irreducible/gangrenous intussusceptions (13), abdominal gunshot injury (2), gangrenous umbilical hernia (2), blunt abdominal trauma (1), midgut volvulus (1), necrotizing enterocolitis (1), strangulated inguinal hernia (1), post-operative band intestinal obstructions (1). There were 16 right hemicolectomies, 4 small bowel resections and 2 massive bowel resections. Average duration of symptoms before presentation was 3.9 days (range: 3 h-14 days). Average time to surgical intervention was 42 h for survivors and 53 h for non-survivors. Only 19% presented within 24 h of onset of symptoms and all survived. For those presenting after 24 h, the cause of delay was a visit to primary or secondary level hospitals (75%) and ignorance (25%). Average duration of post-operative hospital stay is 14 days and 9 patients (41%) developed 18 complications. Seven patients died (31.8% mortality) which diagnoses were irreducible/gangrenous intussusceptions (5), necrotising enterocolitis (1), midgut volvulus (1). One patient died on the operating table while others had overwhelming sepsis. Conclusion: There is a high rate of morbidity and mortality in these cases of preventable bowel resection. Typhoid intestinal perforation did not feature as an indication for bowel resection in this series.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed3739    
    Printed41    
    Emailed0    
    PDF Downloaded241    
    Comments [Add]    

Recommend this journal