Perils of XXXX presenting in neonatal age.

@entity1 @entity4628 @entity17789 @entity1963 @entity1321 @entity298
BACKGROUND: The purpose of this study is to review the cases of @entity1963 seen in the span of ten years at a pediatric surgery unit of a tertiary care public hospital in New Delhi. METHODS: Medical records of twelve @entity1 with @entity1963 were retrieved. RESULTS: Ten out of the twelve @entity1 were males; seven were of the Muslim community. Average recorded birth weight was 2.2 kg. Ten @entity1 presented with features of @entity1321 , while two presented with perforation @entity298 . Among the cases of obstruction, @entity1963 was suspected in eight cases (one was associated with @entity17789 ), one case each was preoperatively diagnosed as @entity4628 and meconium ileus. Abdominal X-rays at presentation of all the neonates except in one with @entity17789 showed multiple air fluid levels. Contrast enema was done in five @entity1 . It showed micro-colon in two @entity1 , and typical question mark sign, dilated small bowel with transition zone in hepatic flexure and normal caliber colon in one each. All the @entity1 underwent exploratory laparotomy. Intra-operatively, the transition zone was seen at distal ileum in ten cases and at hepatic flexure and transverse colon in one each. Biopsies of all the twelve @entity1 eventually showed absence of ganglion cells in entire colon. Ileostomy was done in nine cases, colostomy in two and primary Kimura's procedure in one (this @entity1 was discharged and lost to follow up). Left colonic patch with Swenson's pull through with ileostomy was done for one @entity1 on colostomy. His stoma was closed; he was eventually discharged and lost to follow up. In the other @entity1 with colostomy, the stoma was closed and an ileostomy was created. Of all the @entity1 on ileostomy, three expired in the immediate postoperative period. Four were lost to follow up. Two underwent Kimura's procedure; and expired few months later. One @entity1 on ileostomy is awaiting further treatment. CONCLUSION: The outcomes for @entity1963 in those presenting in neonatal age tend to be unsatisfactory in the developing countries.
