Surgical Management and Outcome of Intestinal Obstruction in Children at Enugu State University Teaching Hospital

Intestinal obstruction in the pediatric population presents unique diagnostic and management challenges in resource-limited settings. This study evaluates the causes, surgical management, and outcome of intestinal obstruction in children aged zero to 12 years admitted to the surgical unit of Enugu State University Teaching Hospital (ESUTH), Enugu State, South East Nigeria, from 2019 to 2023. A retrospective descriptive design was employed, reviewing 140 case records. Data on patient age, sex, clinical presentation, operative findings, type of surgical intervention, and postoperative outcomes were collected and analyzed using SPSS. The leading causes of obstruction included intussusception, Hirschsprung's disease, adhesions, and volvulus. Intussusception was the most common etiology in infants, while postoperative adhesions predominated in older children. Delayed presentation was observed in 55% of cases, contributing significantly to bowel ischemia and resection rates. Postoperative mortality was 9%, largely attributable to sepsis and bowel gangrene. The study recommends early referral protocols, improved diagnostic ultrasound availability, and structured pediatric surgical training programs at secondary care facilities in South East Nigeria to improve outcomes. A regional pediatric surgical emergency response framework is also advised. Keywords: intestinal obstruction, pediatric surgery, intussusception, Enugu, outcomes