NEONATAL INTESTINAL OBSTRUCTION Dr.OMAR ABDULQADER AJAJ PEDIATRIC SURGEON
NEONATAL INTESTINAL
OBSTRUCTION
Dr.OMAR ABDULQADER
AJAJ
PEDIATRIC SURGEON
NIO:- Are the most common
surgical emergencies in the
neonatal period.
NIO:- Occurs in 1/1500 live births.
Causes
1-High intestinal obstruction
Pyloric stenosis
Duodenal atresia
Malrotation
Jejunal atresia
Others
2- Low intestinal obstruction
A-Small bowel involvement
ileal atresia
Meconium ileus
Obstructed inguinal hernia
Others
B-Large bowel involvement
Anorectal malformation
Hischsprung disease
Others
Management
History
Examination
Investigation
Treatment
The common clinical features of NIO
are:
Bilious vomiting,
Failure to pass meconium or delayed
passage of meconium.
Abdominal distension.
Early vomiting in the first 24 hours
indicates high obstruction ( duodenal,
jejunal), while the later onset of vomiting
indicates a lower obstruction ( ileal,
colonic, Hirschsprungs disease and
Anorectal malformation
complications
Failure to recognize neonatal intestinal
obstruction can result in
Aspiration,
Sepsis,
Bowel gangrene, Death
Perforation
Enterocolitis.
Differential diagnosis for nonbilious
vomiting
1- Medical causes such as
gastroesophageal reflux, increased
intracranial pressure, and metabolic
disorders.
2- Anatomic causes include pyloric
stenosis or atresia , antral web.