Abstract

Context: Pediatric intestinal obstruction is a fascinating subject. Because of the specificity of age group, the etiology and management will vastly differ from adult patient and pediatric patients will need very careful management. Because of poor symptomatology and thereafter management initially by either paramedical personnel or unexperienced personnel, the patient suffers a great deal, and early diagnosis and treatment gets usually delayed. Moreover, due to unavailability of trained institutes, morbidity and mortality in this age group significantly rise.In the light of present knowledge, it is possible to outline therapeutic principle which if applied promptly and skillfully, should result in a gratifying outcome to both patient and surgeon in a vast majority of cases. Intestinal obstruction in pediatric age group, due to many differences in aetiology and pathological effects in the body, differs considerably from adult age group. Due to anatomical and physiological difference between these two, the pathological picture and clinical manifestations will vary and accordingly, management also differs. A pediatric patient requires a great deal of scrutinization at every stage of management, diagnosis, preoperative, postoperative etc. The present study is a retrospective study of 30 cases of small intestinal obstruction in pediatric age group which makes a genuine effort to find out the aetiological factors, modes of presentation and special management in them. AIMS •     To study various clinical presentations in pediatric patients of small intestinal obstruction. •     To study the age and sex distribution of different etiological factors. •     To study etiopathology of small intestinal obstruction in pediatric patients. •     To study different treatment modalities in these patients. •     To evaluate the outcome in pediatric intestinal obstruction. Methods and Materials •     Study Settings: Department of General Surgery of teaching hospital attached to medical college •     Study period: Two year •     Sample Size: 30 Cases •     Study Type: Retrospective Study Results: Intestinal obstruction is one of the commonest intra-abdominal pathology encountered in paediatric age group. Cause of intestinal obstruction varies from intussusception, intestinal atresia, worm infestation and obstructed inguinal hernia. The cause of intestinal obstruction also varies with age. Success in treatment of intestinal obstruction depends largely upon early diagnosis, skillful management which comprises of investigations and treatment. Preop-resuscitation, per op-ventilatory and fluid management and post op fluid, nutrition and electrolyte management have an equally important role to play like the surgery itself. Improvement in surgical and anesthetic technique and advances in neonatal and pediatric health care have improved the final outcome in intestinal obstruction. However, being in developing country with a non-ignorable bulk of children suffering from malnutrition and communicable disease, a high degree of suspicion from pediatrician, radiologist and a surgeon working simultaneously for a common task shall always be beneficial for the society. Better understanding of pediatric intensive care and endoscopic advances in the field of surgery shall be able to extend the boundaries of curative treatment and thus further decrease the morbidity and mortality rates. Keywords: Instestinal obstruction; Pediatric age group; Intussusception; Obstructed inguinal hernia; Worm infestation; Early diangnosis; Treatment.

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