Malawi Medical Journal
College of Medicine, University of Malawi and Medical Association of Malawi
Vol. 31, No. 1, 2019, pp. 77-81
Bioline Code: mm19013
Full paper language: English
Document type: Research Article
Document available free of charge
Malawi Medical Journal, Vol. 31, No. 1, 2019, pp. 77-81
© Copyright 2019 - The College of Medicine and the Medical Association of Malawi
Congenital obstructive bowel anomalies presenting after neonatal age|
Ekenze, Sebastian O; Nwangwu, Emmanuel I & Ezomike, Uchechukwu O
Delayed presentation might affect the ultimate management of children with congenital bowel obstructive bowel anomalies (CBA). We
evaluated the profile, challenges of treatment and outcome of CBA presenting after neonatal age.
We did a retrospective analysis of data of children with CBA presenting after neonatal age from January 2013 to November 2017. We used
the Statistical Package for Social Sciences (SPSS) for data entry and analysis.
There were 57 cases in total comprising of Hirschsprung’s disease (HD; 37 cases), anorectal malformation (ARM; 15 cases), and duodeno-jejunal
web (5 cases), with median age of 9 months (IQR 4 months – 2 years) on presentation. Overall, 52 (91.2%) patients had one or more
complications on presentation. Definitive procedure did not differ from established operations, but only 9 (15.8%) had primary procedures
and 48 (84.2%) cases required multi-stage treatment. After an average follow up period of 19.5 months (range: 1 – 45 months), 18 (31.6%)
cases developed procedure-related complications and 3 (5.3%) had residual bowel dysfunction, but there was no mortality. The morbidity
was limited to cases with HD and ARM.
In our setting, HD is the commonest bowel anomaly that presents after the neonatal age. The delayed presentation may predispose to
complications and preclude single-stage treatment in some cases. Training of healthcare providers to improve recognition and early referral
of these anomalies may lead to early diagnosis and minimize morbidity.
congenital bowel anomaly; delayed presentation; challenges; outcome; developing country
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