Congenital paediatric surgical cases in Ibadan: patterns and associated malformations

Abstract

Background: There is paucity of data in the developing countries on the outcome of care of children with congenital anomalies managed in a general paediatric surgical setting. The aim of the study was to describe the pattern of congenital anomalies seen in a single tertiary hospital in Nigeria, highlight associated malformations and evaluate in-hospital outcome of care. Methods: This was a retrospective review of patients who had congenital anomalies of general paediatric surgical nature and had surgery at the hospital over a five-year period. Information was retrieved on sociodemographic characteristics, types of anomalies, associated defects, and in-hospital outcome. Results: Some 540 out of 1,539 patients, 419 (77.6%) males, operated during the period had congenital anomalies. Their ages ranged from 1 day to 23 years (median, 17 months); the majority (58.7%) presented after the first year of life. The most prevalent anomalies were anorectal malformations (51), exomphalos (27) and hypospadias (27). Patients with respiratory anomalies and anterior abdominal wall defects presented earlier compared to others (p < 0.001). Associated major lesions were mostly seen in patients with respiratory (63.6%), anterior abdominal wall (27.6%) and lower gastrointestinal (24.2%) anomalies. Nineteen patients died overall; in-hospital mortality was poorest in those with tracheoesophageal fistula. Conclusion: Birth defects accounted for 35% of the operative workload of this general paediatric surgery unit. The major congenital anomalies seen were in the gastrointestinal and genitourinary systems; most patients presented late and outcome was worst among patients with tracheoesophageal fistula.