Intestinal obstruction in the pediatric age group at Moi Teaching and Referral Hospital, Kenya

Abstract

Background: Intestinal obstruction is the commonest life-threatening emergency all around the world requiring emergency management. It occurs when there is interruption in the forward flow of the intestinal contents. It is a major cause of morbidity and mortality in children in the developing countries. In the pediatric age group, it can be congenital or acquired. This study sought to identify the etiologies and outcomes of intestinal obstruction in the pediatric age group at Moi Teaching and Referral Hospital, Kenya.
Methods: This study was a prospective descriptive study. It included 83 children below 13 years who were operated on for intestinal obstruction between January 2015 to January 2016. Relevant data on clinical presentation, duration of onset of symptoms, investigations and intraoperative findings were entered into the data collection sheet. Daily follow up was done until discharge or in-hospital death, and outcomes recorded.
Results: A total of 83 patients were studied. Age of the patients ranged from 1 day to 13 years old, with a mean of 2.67 (SD ± 2.2) years. Neonates constituted 38.6% of the study participants. The male to female ratio was 2.95:1. The most common etiology was intussusception (30.1%). The complication rate was 16.9%. The average length of hospitalization was 7.9±5.3 days. The in-hospital mortality was 16.9%.
Conclusion: The commonest aetiology of intestinal obstruction in the pediatric age group at Moi teaching and referral hospital is intussusception. Mortality and morbidity rates are high. Factors co-related with mortality are deranged potassium level, neonates, referrals, development of complications and late presentation (>24hrs).