Eight Years Experience with The Management and Outcome of Congenital Gastrointestinal Anomaly in A Nigerian Tertiary Hospital

Abstract

The treatment of congenital gastrointestinal anomaly is associated with high morbidity and mortality especially in developing countries. This study reports 8-year experience with the, pattern of presentation and factors influencing outcome of management in a Nigerian tertiary hospital. This is a retrospective study on children diagnosed with congenital gastrointestinal anomaly at the University of Benin Teaching Hospital, Benin City, Nigeria, between January 2000 and December 2007. A total of 258 operations were done on 189 children with congenital gastrointestinal anomaly. They comprised of 128 males and 61 females with male/female ratio 2.1:1 and mean age 4.9 ± 3.8 months (range 12 hours to 12 years). Anorectal anomaly 75 (39.7%) and Hirschsprung's disease 57 (30.2%) were the commonest indications for treatment. Eight-one (42.9%) children were operated as neonates with a resultant 29.6% mortality compared with 15.7% mortality recorded among 108 operated after neonatal period (P= 0.0345). Twenty-eight (14.8%) children had multiple anomaly with 5 (83.3%) deaths recorded among six with associated cardiac anomaly (P<0.0001). Upper gastrointestinal anomalies with 14 (46.7%) mortalities and ventral abdominal wall defects with 14 (51.9%) were compared to lower gastrointestinal anomalies with 13 (9.8%) (P<0.0001). Overall, 33.5% morbidity were recorded which resulted in 21.7% mortality. This was influenced by the type of lesion, delayed presentation, surgery on the newborn, sepsis, and lack of facilities required for management. Congenital gastrointestinal anomaly was associated with poor outcome. Early presentation, provision of facilities, health awareness campaign and improvement in government policies which will enable children have access to free medical treatment will lead to improved results.

Keywords: , Congenital, gastrointestinal, anomaly, treatment outcome