neonatalintestinalobstruction-150208040657-conversion-gate02.pdf

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2. Most common surgical emergency in
neonates.
Management depends on timely diagnosis
Needs radiological assessment
Outcome excellent

3. Refusal to take feed.
Vomitting.
Abdominal distention.
Delayed/failure to pass meconium.

4. HIGH INTESTINAL OBSTRUCTION
proximal to ileum i.e. gastric ,duodenal
& jejunal.
LOW INTESTINAL OBSTRUCTION
distal ileum & colon.

6. HIGH INTESTINAL OBSTRUCTION

7. Rare
Usually distal
AXR—gas filled stomach without distal
intestinal air. SINGLE BUBBLE SIGN.
Can be dx antenatally on ultrasound.

11. Congenital failure of recanalization.
Association with VATER/VACTERL & trisomy
21.
Post-ampullary.
Bilous vomitting.

12. On AXR gas filled distended stomach &
duodenal cap.
Absent distal bowel gases,

18. Gastro duodenal distention but distal gases
present.
On contrast– slow transit of contrast distally.

21. Small congenital obstructive membrane with
central aperture.

23. Failure of normal physloiogical herniation in
embryo
Leads to narrow mesenteric attachment.
Predisposes to rotation around superior
mesenteric vessels.
If untreated bowel ischemia & infarction.

27. Abnormal course of duodenum that fail to
cross midline has spiral appearance .

31. Intestinal ischemia during intra uterine life.
Present with bilous vomitting & abdominal
distention.

32. Distention of stomach ,duodenum &
jejunum.

35. LOW INTESTINAL OBSTRUCTION

36. Due to intra uterine ischemic insult.
Bilous vomiting & distention.
Numerous dilated bowel loops.

39. Meconium plugs obstruct colon & distal small
bowel.
Associated with cystic fibrosis.
AXR– multiple distended gut loops.
Contrast study—meconium plugs & micro
colon.

43. Meconium plug /small left colon syndrome.
Benign & self limiting condition.
Due to immaturity of colonic ganglion cells.
To infants of diabetic mothers & those who
took MgSO4 for pre eclampsia.

44. Contrast studies-
dilated ascending & transverse colon
small descending colon
rectum normal

47. Arrest of neuron migration to distal bowel
before 12
th
week.
rectosigmoid-75%
splenic flexure-20%
whole colon-5%

48. Affected segment narrowed.
Proximal dilatation.

52. Rarely an uncommon condition
Intra uterine vascular insult
Proximal to splenic flexure

55. Association with VATER
High/low depending levator ani muscle
Low –blind ending pouch.
High-associated with fistula to
bladder,urethra & vagina.