Abstract:
Background: Intestinal obstruction constitutes the largest proportion of abdominal surgical emergencies in the
paediatric and adult patients in Sub-Saharan Africa, including Kenya. It is associated with high postoperative surgical
complication and mortality rate in low resource healthcare systems.
Methods: A prospective mixed methods study with consecutive sampling procedure was carried out from September
2021 to June 2023. Pediatric patients from birth to 14 years, with mechanical intestinal obstruction were included in
the study. Categorical data was analyzed in frequencies and percentages and continuous data was analyzed using
measures of central tendency and measures of dispersion. Bivariate and multivariate associations between the
dependent and independent variables were assessed with a p value of less than 0.05 being statistically significant.
Results: The final study population was 318 participants. Majority of participants were male with neonates
comprising almost one third of participants. Classical symptoms were present in a majority of patients at initial
presentation. Intussusception (34.6%) was the leading acquired aetiology of paediatric mechanical intestinal
obstruction. Operative surgical management was in 94.6% of participants. Surgical complications were present in
61.1% of participants. The commonest surgical complication was surgical site infection in 16.9%. Overall mortality
rate was 10.2% with 23.3% among neonates and 4.9% in older children. Referral status was statistically associated
with mortality (p<0.001). Intestinal atresia had the highest case-specific mortality rate. Age, presence of comorbidity
were factors associated to postoperative complications and mortality (p<0.05).
Conclusions: The overall mortality rate was 10.2%. A higher mortality was seen among neonates compared to older
children.
