Management of jejunoileal atresias: an experience at eastern Nepal

BMC Surgery

Research Article

Pramod Shrestha¹  Prakash Poudel¹  Shailesh Adhikary²  Chandra S Agrawal²  Vikal C Shakya²  Sudeep Khaniya² 

[1] Department of Pediatrics, B. P. Koirala Institute of Health Sciences, Dharan, Nepal;Department of Surgery, B. P. Koirala Institute of Health Sciences, Dharan, Nepal;

关键词: Total Parenteral Nutrition;    Short Bowel Syndrome;    Parastomal Herniation;    Ileostomy Closure;    Type IIIb;   

DOI  :  10.1186/1471-2482-10-35

 received in 2010-08-11, accepted in 2010-11-26,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundIntestinal atresia is a common cause of neonatal intestinal obstruction, and management of this disease in limited setup of a developing country is very difficult.MethodsThis study is a retrospective study of patients with jejunoileal atresias and their postoperative outcome in a teaching hospital in eastern Nepal over a 5-year period.ResultsThere were 28 children (19 boys and 9 girls). 11 children (39.28%) had jejunal atresia and 17 (60.71%) had ileal atresia. Eight (28.5%) patients died, 6 were jejunal atresia (54.5%) and 2 were ileal atresia (11.7%). The most common cause of death was sepsis which occurred in 7 out of 8 cases (87.5%). The risk factors for mortality identified were leucopenia, neutropenia, delay in surgery, location of atresia and type of atresia. Jejunal atresia tended to have a higher mortality than ileal atresia, and severe types of atresia (type IIIb and IV) were more often associated with mortality than other types of atresia. The significant differences between jejunal and ileal atresia were the increased duration between presentation and surgery, longer postoperative and total hospital stay, presence of more severe atresias and an increased risk of mortality in case of jejunal atresias.ConclusionThe prognosis for this disease have definitely changed in the last few decades in developed countries but in our environment, problems like late presentation and diagnosis, lack of availability of good neonatal intensive care units and parenteral nutritional support still prevail.

【 授权许可】

CC BY   
© Shakya et al; licensee BioMed Central Ltd. 2010. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.