AN OVERVIEW OF NEONATAL INTESTINAL OBSTRUCTION: A REVIEW OF LITERATURE.
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Keywords

Neonate, Intestine, Colon, Anorectum, Bowel, Obstruction, Congenital, Mechanical, Functional, Resuscitation

Abstract

Aim: To highlight the common causes, pathophysiology, clinical features, diagnostic investigations and treatment of the common differentials of neonatal intestinal obstruction.
Method: Review of literature was done which encompassed common causes, pathophysiology, clinical features, diagnostic investigations and treatment of the common differentials of neonatal intestinal obstruction.
Result: Neonatal Intestinal Obstruction, the inhibition of flow of intestinal content, is mostly caused by congenital surgical conditions which result in mechanical or functional obstruction. Mechanical obstruction could be intraluminal e.g. Meconium ileus/plug; intramural e.g. Atresia, Stenosis and extramural e.g. Bands. Common examples of functional obstruction include Hirschsprung’s disease and Neonatal sepsis.
The pathophysiology results in hypovolaemia and bacteria-translocation. The clinical features include abdominal distension, constipation, bilious vomiting, dehydration, hypothermia/fever.
Prenatal ultrasound finding of polyhydramnios is suggestive of pathologies like duodenal atresia. Postnatal, diagnosis is confirmed by abdominal radiograph (bowel dilatation and air-fluid levels) or contrast studies e.g. corkscrew appearance in malrotation.
Treatment includes fluid-electrolyte resuscitation, nasogastric decompression, antibiotics, vital signs/hourly urine monitoring and definitive surgical procedure.
Conclusion: Neonatal intestinal obstruction is a common surgical emergency amongst neonates for which early diagnosis and intervention, as well as support care facilities and trained staff of different specialties are crucial to having a good outcome.

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