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.