Clinical Profile and Surgical Outcomes of Neonates with Intestinal Obstruction: A Five-Year Retrospective Study at Al-Karami Teaching Hospital, Kut, Iraq

Abstract

Background: Neonatal intestinal obstruction (NIO) is one of the most severe emergencies of neonatal surgery. Early diagnosis and timely operative procedure is necessary to avoid life-threatening complications, such as bowel ischemia, perforation, and sepsis. Methods: It was a retrospective observational study that examined all neonate surgical cases (age ≤28 days) with confirmed mechanical intestinal obstruction of Al-Karami Teaching hospital, Al-Kut, Iraq, between January 2019 and December 2023. Demographics, ante-natal history, clinical presentation, radiographic studies, operative information, histopathologic diagnosis, post-operative complications and 30 days in-hospital mortality were analyzed in a systematic manner. Results A total of 87 neonates were recruited (male 59.8%, preterm 24.1%). Jejunoileal atresia (34.5%), malrotation with volvulus (21.8%), and Hirschsprung’s disease (16.1%) were the most common etiologies. Obstructive anomalies were detected in 32.2% of cases by antenatal ultrasonography. Bilious vomiting (87.4%), abdominal distension (70.1%), and inability to pass meconium within 48 hours (56.3%) were the most common presenting features. Definitive surgical correction was done in all patients. The incidence of postoperative complications was 25.3% with wound infection (9.2%), sepsis (6.9%), and anastomotic leakage (5.7%) being the most common. The overall in-hospital mortality stood at 6.9%, with cases of malrotation/volvulus or obstruction caused by NEC occurring after 72 hours. Mean hospital stay was 12.4 ± 6.2 days. Conclusions: NIO continues to be an important contributor to neonatal morbidity and mortality in resource-restrained environments. In this institutional series morbidity and mortality rates are favorable to regional standards. Key interventions to improve outcomes include enhanced antenatal screening, early clinical recognition, and coordinated perioperative multidisciplinary care.