Publication:

Intestinal atresia: a retrospective study of 36 neonates and risk factors to mortality in Tertiary care center, Tripura

Background Intestinal atresia among neonates is still a condition which has huge morbidity and mortality, particularly in the developing world. We share a case series of intestinal atresia in context of their presentation, management and outcome.

Methods This study was conducted at Tripura Medical College and DR BRAM Teaching hospital, Tripura, over 1 year. We included all patients presenting with jejunoileal atresia, duodenal atresia and their demographic details, presentation, investigations, treatment strategies and the outcome were noted at a pre-designed proforma. All data were analysed using SPSS version 26.

Results A total of 36 neonates with intestinal atresia were included. Most of them (77.78%) presented after 48 h of life and the mean age at presentation was 5.68±4.75 days. There were 22 male patients (61.11%) and 30 (83.33%) were full-term. The most common presenting complaint was not being able to pass meconium (88.89%). Type III atresia was the most common subtype (41.67%). Most of them underwent resection without tapering. The mean hospital stay was 12.81±6.53 and it was significantly longer among those who underwent re-exploration (P=0.034). 13 patients (36.11%) expired within 6 months of follow-up. The only significant factor for mortality was the presence of short bowel syndrome (P=0.036). All other demographic and management factors did not alter the mortality rate.

Conclusions Management of surgical neonates is a difficult job in developing countries with limited resources. There is a high mortality rate of neonates following intestinal atresia surgeries and surgeons in these countries must fight on many fronts to improve the outcome.