Metabolic profile and outcome of pre- and post-ampullary gastrointestinal obstruction in children: Conventional or unconventional wisdom
Background: Conventionally, it is well accepted that the intestinal obstructions in children, especially gastric outlet obstruction are associated with significant metabolic derangement which has impact on its outcome. The study aimed to compare the metabolic profile and treatment outcome of pre- an...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2020-01-01
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| Series: | African Journal of Paediatric Surgery |
| Subjects: | |
| Online Access: | http://www.afrjpaedsurg.org/article.asp?issn=0189-6725;year=2020;volume=17;issue=1;spage=18;epage=22;aulast=Syal |
| _version_ | 1818400193378254848 |
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| author | Sarita Syal Amita Sen Nidhi Sugandhi Monika Nanda Avinash Jhadav |
| author_facet | Sarita Syal Amita Sen Nidhi Sugandhi Monika Nanda Avinash Jhadav |
| author_sort | Sarita Syal |
| collection | DOAJ |
| description | Background: Conventionally, it is well accepted that the intestinal obstructions in children, especially gastric outlet obstruction are associated with significant metabolic derangement which has impact on its outcome. The study aimed to compare the metabolic profile and treatment outcome of pre- and post-ampullary gastrointestinal obstruction in children at a tertiary care setting. Materials and Methods: A prospective observational study was conducted on 30 children with intestinal obstruction and categorised into Group 1 (pre-ampullary, n = 11) and Group 2 (post-ampullary, n = 19) as per their anatomical site of pathology. Patients were evaluated at both pre- and post-operative period (Day 1 and 10) with haematological, biochemical and blood gas. The pre- and post-operative metabolic profile, resuscitative time and outcome were compared in two groups. Results: Except mild leucocytosis (Group II > I), rest of the pre-operative and post-operative haematological parameters were within normal range and statistically comparable among groups. Although the pre-operative sodium values were within the normal limit in both groups, it was relatively higher in Group I (Group I = 137.82 ± 4.238 vs. Group II = 134.26 ± 4.653), (P = 0.04). The mean bicarbonate values were within the normal limit in both groups (22.49 and 19.34), but the difference was statistically significant (P = 0.031). Mean partial pressure of carbon dioxide level was higher than normal range in Group I (38.464 ± 20.6493) but was comparable with Group II (P = 0.15). The time required for pre-operative resuscitation was 16.6 versus 24.87 h in Group I versus Group II (P = 0.02). In Group I, all children were improved, whereas four children expired in Group II. Conclusion: Metabolic profile in both pre- and post-ampullary intestinal obstruction was found to be normal in majority of the scenario. Children with post-ampullary obstruction need extensive pre-operative resuscitation and have relatively poor outcome. |
| first_indexed | 2024-12-14T07:32:41Z |
| format | Article |
| id | doaj.art-aa3207c864974617997146da8be1ac8c |
| institution | Directory Open Access Journal |
| issn | 0189-6725 |
| language | English |
| last_indexed | 2024-12-14T07:32:41Z |
| publishDate | 2020-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | African Journal of Paediatric Surgery |
| spelling | doaj.art-aa3207c864974617997146da8be1ac8c2022-12-21T23:11:20ZengWolters Kluwer Medknow PublicationsAfrican Journal of Paediatric Surgery0189-67252020-01-01171182210.4103/ajps.AJPS_27_17Metabolic profile and outcome of pre- and post-ampullary gastrointestinal obstruction in children: Conventional or unconventional wisdomSarita SyalAmita SenNidhi SugandhiMonika NandaAvinash JhadavBackground: Conventionally, it is well accepted that the intestinal obstructions in children, especially gastric outlet obstruction are associated with significant metabolic derangement which has impact on its outcome. The study aimed to compare the metabolic profile and treatment outcome of pre- and post-ampullary gastrointestinal obstruction in children at a tertiary care setting. Materials and Methods: A prospective observational study was conducted on 30 children with intestinal obstruction and categorised into Group 1 (pre-ampullary, n = 11) and Group 2 (post-ampullary, n = 19) as per their anatomical site of pathology. Patients were evaluated at both pre- and post-operative period (Day 1 and 10) with haematological, biochemical and blood gas. The pre- and post-operative metabolic profile, resuscitative time and outcome were compared in two groups. Results: Except mild leucocytosis (Group II > I), rest of the pre-operative and post-operative haematological parameters were within normal range and statistically comparable among groups. Although the pre-operative sodium values were within the normal limit in both groups, it was relatively higher in Group I (Group I = 137.82 ± 4.238 vs. Group II = 134.26 ± 4.653), (P = 0.04). The mean bicarbonate values were within the normal limit in both groups (22.49 and 19.34), but the difference was statistically significant (P = 0.031). Mean partial pressure of carbon dioxide level was higher than normal range in Group I (38.464 ± 20.6493) but was comparable with Group II (P = 0.15). The time required for pre-operative resuscitation was 16.6 versus 24.87 h in Group I versus Group II (P = 0.02). In Group I, all children were improved, whereas four children expired in Group II. Conclusion: Metabolic profile in both pre- and post-ampullary intestinal obstruction was found to be normal in majority of the scenario. Children with post-ampullary obstruction need extensive pre-operative resuscitation and have relatively poor outcome.http://www.afrjpaedsurg.org/article.asp?issn=0189-6725;year=2020;volume=17;issue=1;spage=18;epage=22;aulast=Syalgastrointestinal obstructionmetabolic profilepost-ampullarypre-ampullary |
| spellingShingle | Sarita Syal Amita Sen Nidhi Sugandhi Monika Nanda Avinash Jhadav Metabolic profile and outcome of pre- and post-ampullary gastrointestinal obstruction in children: Conventional or unconventional wisdom African Journal of Paediatric Surgery gastrointestinal obstruction metabolic profile post-ampullary pre-ampullary |
| title | Metabolic profile and outcome of pre- and post-ampullary gastrointestinal obstruction in children: Conventional or unconventional wisdom |
| title_full | Metabolic profile and outcome of pre- and post-ampullary gastrointestinal obstruction in children: Conventional or unconventional wisdom |
| title_fullStr | Metabolic profile and outcome of pre- and post-ampullary gastrointestinal obstruction in children: Conventional or unconventional wisdom |
| title_full_unstemmed | Metabolic profile and outcome of pre- and post-ampullary gastrointestinal obstruction in children: Conventional or unconventional wisdom |
| title_short | Metabolic profile and outcome of pre- and post-ampullary gastrointestinal obstruction in children: Conventional or unconventional wisdom |
| title_sort | metabolic profile and outcome of pre and post ampullary gastrointestinal obstruction in children conventional or unconventional wisdom |
| topic | gastrointestinal obstruction metabolic profile post-ampullary pre-ampullary |
| url | http://www.afrjpaedsurg.org/article.asp?issn=0189-6725;year=2020;volume=17;issue=1;spage=18;epage=22;aulast=Syal |
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