Prevalence, interventions and outcomes of gastrointestinal surgical conditions in neonates

Background: Gastrointestinal surgical conditions in neonates are a significant concern in pediatric surgery, associated with high morbidity and mortality rates. Early identification and management of these conditions are crucial for improving outcomes.

Objective: This study aims to investigate the prevalence, surgical interventions, clinical outcomes, and associated factors of gastrointestinal surgical conditions in neonates, providing insights to enhance neonatal care.

Methods: Medical records for 59 neonates admitted with gastrointestinal surgical conditions in Khartoum Teaching Hospital and Ibrahim Malik Teaching Hospital between January 2020 and August 2022 were retrospectively reviewed. Data collected included socio-demographic information, maternal and birth histories, clinical presentations, surgical interventions, and short-term outcomes. Statistical analyses were performed to identify correlations between various factors and clinical outcomes.

Results: 59 cases of neonates with gastrointestinal surgical conditions were included. The male-to-female ratio of 1.2:1 and a term-to-preterm ratio of 7.4:1. The most common conditions included anorectal malformations 16 (27.1%), Hirschsprung disease 13 (22%), jejunal atresia 11 (18.6%), and malrotation 9 (15.3%). Surgical interventions were critical, with colostomy in 19 (32.2%), anoplasty in 14 (23.7%), and laparotomy in 9 (15.2%) being the most frequently performed procedures. The study reported a mortality rate of 23.7%, primarily due to complications such as respiratory failure and sepsis, particularly in cases of jejunal atresia and anorectal malformations. Statistical analysis revealed significant correlations between lower birth weight, absence of antenatal diagnosis, and poorer outcomes.

Conclusion: This study highlights the substantial challenges posed by gastrointestinal surgical conditions in neonates, emphasizing the need for prompt surgical intervention and comprehensive care strategies. Understanding the specific conditions, associated risks, and outcomes is vital for optimizing management and improving prognosis. Future efforts should focus on enhancing antenatal screening protocols and fostering early diagnosis and treatment, which may improve outcomes for this vulnerable population.