Neonatal Small Bowel Obstruction in Alexandria, Egypt.

Background: Small bowel obstruction is one of the major causes of morbidity and mortality in surgical newborns. The purpose of this study was to determine causes and surgical outcomes of small intestinal obstruction in neonates.
Methods: This prospective study was done at El Shatby Alexandria University paediatric surgery teaching hospital, Egypt between February 2014 and February 2015, involving neonates (≤ 30 days of life) who were operated for acute small intestinal obstruction. Collected data were analysed for patients` and maternal demographic characteristics, clinical presentations, aetiology, management and outcomes.
Results: Fifty two newborns were studied, males being 55.8% (29) with the males to females of 1.3:1. The commonest aetiology was intestinal atresia 38.5% (20) followed by intestinal malrotation 21.2% (11). Most of babies presented late to hospital 59.6% (31). Associated anomalies and preoperative medical conditions occurred mainly in low birth weight, premature, late presenters and intestinal atresia newborns. Twelve (23.1%) cases had postoperative complications which occurred frequently among late presenters and the commonest postoperative complication was wound sepsis 52.0% (13/25). Mortality was 21.2% (11) and was high in underweight neonates, P=0.05, in prematures, females, newborns with associated anomalies and preoperative medical conditions.
Conclusion: Postoperative morbidity and mortality are high in neonatal small bowel obstruction. Late presentation, low birth weight, prematurity, associated anomalies and preoperative medical conditions are the main determinants of adverse outcomes.