Pediatric intestinal obstruction in Malawi: characteristics and outcomes

作者：Shah Mansi; Gallaher Jared; Msiska Nelson; McLean Sean E; Charles Anthony G^*

来源：American Journal of Surgery, 2016, 211(4): 722-726.

DOI：10.1016/j.amjsurg.2015.11.024

• Obstruction
• Malawi
• Pediatric surgery
• Hirschprung's disease
• Imperforate anus
• Intussusception

BACKGROUND: Intestinal obstruction (IO) is a common pediatric surgical emergency in sub-Saharan Africa with high morbidity and mortality, but little is known about its etiopathogenesis in Malawi.
METHODS: Retrospective analysis of patients seen from February 2012 to June 2014 at Kamuzu Central Hospital in Lilongwe, Malawi (n = 3,407). Pediatric patients with IO were analyzed (n = 130).
RESULTS: Overall, 57% of patients were male with a mean age of 3.5 +/- 4.1 years. A total of 52% of patients underwent operative intervention. The overall mortality rate was 3%. Leading causes of IO were Hirschprung's 29%, anorectal malformation 18%, and intussusception 4%. Neonates and patients with congenital causes of IO underwent surgery less frequently than infants and/or children and patients with acquired causes, respectively. These groups also demonstrated increased number of days from admission to surgery.
CONCLUSIONS: Increasing pediatric-specific surgical education and/or training and expanding access to resources may improve mortality after IO in poor medical communities within sub-Saharan Africa.

• 出版日期2016-4