Unveiling the unexpected: retrospective observational study on uncommon pediatric gastrointestinal obstructions.

Abstract

Background:

Intestinal obstruction is a common pediatric surgical emergency. Although most cases are attributed to well-recognised etiologies such as intussusception, congenital atresias, malrotation, and adhesions, rare causes may present significant diagnostic and therapeutic challenges. Delayed diagnosis can lead to bowel ischemia, perforation, and increased morbidity.

 Objective:

To describe the clinical presentation, radiological findings, surgical management, and outcomes of uncommon causes of pediatric intestinal obstruction encountered at a tertiary care centre.

 Methods:

 A retrospective review was conducted on eleven pediatric patients who underwent surgery for acute intestinal obstruction between January 2022 and December 2024. Clinical records, imaging findings, operative notes, and histopathology reports were analyzed.

 Results:

The patients ranged from neonates to 13 years of age. Rare etiologies identified included mesenteric lymphangioma with midgut volvulus, inflammatory band with internal herniation, congenital diaphragmatic hernia with gastric volvulus, vitellointestinal cyst, jejunal intussusception, duodenal web associated with Down syndrome, ileo-ileal knotting, ileocolic intussusception secondary to ileal tumor, bowel mucormycosis, idiopathic gastric obstruction, and left mesocolic hernia. Surgical intervention resulted in favorable outcomes in the majority of patients.

 Conclusion:

Rare causes of intestinal obstruction should be considered in children presenting with atypical features. Early recognition and prompt surgical intervention are essential to reduce morbidity and improve outcomes.