Gastrointestinal obstruction in the pediatric age group may be due to a variety of congenital and acquired conditions. Over a period of 18 months; 150 cases of acute intestinal obstructions accounted for 40% of the abdominal emergencies at our center. Children with esophageal atresia, anorectal ano-malies, Hirschsprung’s disease, adhesive intestinal obstruction not requiring surgery, and peritonitis without mechanical obstruction were excluded.

Seventy eight percent (118) were males and 32(22%) were females (M: F: 3.6:1). The children aged between 1-12 months constituted 42% (n=63) of the patients and 35% (n=53) were neonates.

Etiological distribution of the cases is shown in Fig.1. Intestinal atresias were the commonest and accounted for 22.4% (n=34) of the cases. Malrotation (n=11), congenital band obstruction (n=3), meconium pseudocyst (n=2), Obstructed hernia (n=1), duplication cyst jejunum (n=1) and infantile hypertrophic pyloric stenosis (n=1) were other causes of obstruction in neonates. Out of 23 (15%) patients of intussusception, 18(76%) were between 6 month to 1 year of age and only 59%(16) of the patients had bleeding per rectum. Pathological lead point (PLP) was seen in 4 (19%) patients of ileocolic intussusception. Of the 20 patients of malrotation, 11 (55%) were less than one month old, 5(25%) between 1 month and 1year and 4 (20%) were 1 to 6 years.

Fig. 1 Distribution of etiology of gastrointestinal obstruction in children.

Many studies in Western and South African countries show similar etiological prevalence as in our institute(1-3). However, there were several differences observed in the presentations in different groups of GIO as compared to the classical descriptions(1,4,5). Intussusception occurred below 1year of age in 76%(18) of our patients and PLP was present in 19% of them, unlike the previous reports in the literature. Bleeding per rectum was seen in 59% of the patients only, compared to a higher incidence reported by others. Fifty five percent of our patients presented with malrotation in the neonatal period, in contrast to 75% neonatal presentations described in the literature. The intestinal obstruction in malrotation may be waxing and waning type and requires a high index of suspicion so as not to miss the diagnosis.

1. Ameh EA, Chirdan LB. Neonatal intestinal obstruction in Zaria, Nigeria.East Afr Med J 2000; 77: 510-513.

2. Rescorla FJ, Grosfeld JL. Intestinal atresia and stenosis: Analysis of survival in 120 cases. Surgery 1985; 98: 668-676.

3. DallaVecchia LK, Grosfeld JL, West KW, Rescorla FJ, Scherer LR, Engum SA. Intestinal atresia and stenosis: a 25-year experience with 277 cases. Arch Surg 1998; 133: 490-497.

4. Adejuyigbe O, Fashakin EO. Acute intestinal obstruction in Nigerian children. Trop Gastroenterol 1989; 10: 33-40.