Incidence of postoperative adhesion obstruction following neonatal laparotomy.
Of 649 neonates undergoing laparotomy in a 10 year period, 54 (8.3 per cent) developed adhesion related intestinal obstruction requiring surgical treatment. In 16 infants the obstruction followed a period of prolonged postoperative ileus, while the remaining 38 had completely recovered from the previous surgical procedure before the development of obstruction. The adhesion obstruction occurred after a single neonatal laparotomy in 35 cases but the remaining 19 had undergone subsequent laparotomies; 75 per cent of the obstructions developed within 6 months and 90 per cent within 1 year of surgery. The highest risk groups were infants undergoing correction of gastroschisis (15.4 per cent) and malrotation (15 per cent). There were nine deaths, two of which were a direct consequence of the adhesion obstruction.
D006801:Humans; D007231:Infant, Newborn; D007415:Intestinal Obstruction / Q000209:etiology* / Q000401:mortality; D007813:Laparotomy / Q000009:adverse effects*; D012086:Reoperation; D012306:Risk; D013997:Time Factors; D000267:Tissue Adhesions / Q000209:etiology / Q000401:mortality