S. Adamu, S. Wabada, A.M Abubakar, I. Jalo, S.A Faruq, C. Nwosu, K.J Bwala, K. Ofozor
Paediatric Surgery Unit, Department of Surgery, Federal Teaching Hospital and Gombe State University, Gombe, Nigeria.
Abstract
Background: Mortality associated with neonatal surgical emergencies is high, due to late presentation and delayed surgical intervention in developing countries. The aim of this study is to determine factors associated with poor outcome of neonatal surgical emergencies at a Federal Teaching Hospital Northeastern Nigeria.
Methods: A retrospective study of 85 neonates aged 1-28 days was carried between June 2019-May 2022. Records of the neonates with surgical emergencies were retrieved and analyzed with the SPSS Version 20.
Results: A total of 85 neonates, 55 (64.8%) males and 30(35.3%) females were analyzed. The average duration of symptoms at presentation is about 5.3-day range 1-10days. About 51(60.0%) neonates presented after 24 hours of life 34(40.0%) within 24 hours of life, out of which were 12(35.3%) neonates with gastroschisis presenting after 8hours with severe hypothermia axillary temperature of 32.1o Celsius. The 46 (90.2%) neonates presenting after 24hours of life had travelled distances of 50- 100Kms to get to the hospital, out of which about 31(67.4%) arriving the following day, with about 9(29.0%) who had gastroschisis noticed to be lifeless at presentation. Overall, about 26(30.6%) died due to late presentation, delayed surgical intervention and lack radiant warmers.
Conclusion: Late presentation delayed surgical intervention are common causes of mortality in neonates with surgical emergencies in Gombe
Keywords: Neonatal surgical emergencies, Late presentation, Delayed surgical intervention
Correspondence:
Dr. S. Adamu
Department of Surgery, Federal Teaching Hospital and
Gombe State University,
Gombe, Nigeria. modibbosaniadamu@gmail.com
Submission Date: 15th June, 2023
Date of Acceptance: 1st April, 2024
Publication Date: 30th April, 2024
Introduction
The last 60 years has witnessed a tremendous improvement in outcome of treatment of neonatal surgical emergencies in the developed world due to availability of specialist surgical care, early presentation and intervention, improved anaesthetic care and diagnostic facilities.1 Unlike in developing countries where the outcome is still poor due to non-availability of resources and untrained man power.2 The ability to provide timely and effective surgical care to newborns in these settings is crucial not only for immediate survival but also for long-term health and well-being. Even though progress have been made over the years in our region as in the study by Ekwunife et al.3, there seems to be more work to be done. The Federal Teaching Hospital, Gombe is the only tertiary healthcare in this region, saddled with the complex task of managing neonatal surgical cases. This underscores the importance of reviewing our experience with the management of neonatal surgical cases. Our aim therefore is to determine preoperative factors associated with poor outcome of treatment of neonatal surgical emergencies at Federal Teaching Hospital, Gombe in Northeastern Nigeria.