Co esponding au ho : Ome Saeed Magzoub
Copy igh © 2025 Au ho (s) e ain he copy igh o his a icle. This a icle is published unde he e ms o he C ea i e Commons A ibu ion Liscense 4.0.
P e alence, in e en ions and ou comes o gas oin es inal su gical condi ions in
neona es
Ome Saeed Magzoub 1, *, Sahwa El ahi Mohamed Ome 2, and Rasha Sidahmed Elhassan Oma 3
1 Specialis Gene al Pedia ic, Ain Al-Khaleej Hospi al, Al-Ain, UAE.
2 Pedia ic Senio Regis a , Sudan Medical Specializa ion Boa d, Kha oum, Sudan.
3 Pedia ician, AHS – SEHA, Al-Ain, UAE.
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 27(02), 1458-1464
Publica ion his o y: Recei ed on 10 July 2025; e ised on 17 Augus 2025; accep ed on 19 Augus 2025
A icle DOI: h ps://doi.o g/10.30574/wja .2025.27.2.2963
Abs ac
Backg ound: Gas oin es inal su gical condi ions in neona es a e a signi ican conce n in pedia ic su ge y, associa ed
wi h high mo bidi y and mo ali y a es. Ea ly iden i ica ion and managemen o hese condi ions a e c ucial o
imp o ing ou comes.
Objec i e: This s udy aims o in es iga e he p e alence, su gical in e en ions, clinical ou comes, and associa ed
ac o s o gas oin es inal su gical condi ions in neona es, p o iding insigh s o enhance neona al ca e.
Me hods: Medical eco ds o 59 neona es admi ed wi h gas oin es inal su gical condi ions in Kha oum Teaching
Hospi al and Ib ahim Malik Teaching Hospi al be ween Janua y 2020 and Augus 2022 we e e ospec i ely e iewed.
Da a collec ed included socio-demog aphic in o ma ion, ma e nal and bi h his o ies, clinical p esen a ions, su gical
in e en ions, and sho - e m ou comes. S a is ical analyses we e pe o med o iden i y co ela ions be ween a ious
ac o s and clinical ou comes.
Resul s: 59 cases o neona es wi h gas oin es inal su gical condi ions we e included. The male- o- emale a io o 1.2:1
and a e m- o-p e e m a io o 7.4:1. The mos common condi ions included ano ec al mal o ma ions 16 (27.1%),
Hi schsp ung disease 13 (22%), jejunal a esia 11 (18.6%), and mal o a ion 9 (15.3%). Su gical in e en ions we e
c i ical, wi h colos omy in 19 (32.2%), anoplas y in 14 (23.7%), and lapa o omy in 9 (15.2%) being he mos equen ly
pe o med p ocedu es. The s udy epo ed a mo ali y a e o 23.7%, p ima ily due o complica ions such as espi a o y
ailu e and sepsis, pa icula ly in cases o jejunal a esia and ano ec al mal o ma ions. S a is ical analysis e ealed
signi ican co ela ions be ween lowe bi h weigh , absence o an ena al diagnosis, and poo e ou comes.
Conclusion: This s udy highligh s he subs an ial challenges posed by gas oin es inal su gical condi ions in neona es,
emphasizing he need o p omp su gical in e en ion and comp ehensi e ca e s a egies. Unde s anding he speci ic
condi ions, associa ed isks, and ou comes is i al o op imizing managemen and imp o ing p ognosis. Fu u e e o s
should ocus on enhancing an ena al sc eening p o ocols and os e ing ea ly diagnosis and ea men , which may
imp o e ou comes o his ulne able popula ion.
Keywo ds: P e alence; In e en ions; Ou comes; Gas oin es inal Su gical Condi ions; Neona es
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 27(02), 1458-1464
1459
1. In oduc ion
Congeni al and acqui ed gas oin es inal ac diseases a e gene ally a e, wi h p e alence a es a ying be ween 1 in
300 and less han 1 in 10,000 [1]. Congeni al mal o ma ions pose a subs an ial challenge o pedia ic su gical ca e in
e ia y cen e s, wi h gas oin es inal ac (GIT) mal o ma ions anking as he hi d mos common ype. In high-income
coun ies (HICs), hese condi ions a e o en iden i ied p ena ally o du ing he neona al pe iod, enabling ea ly
in e en ion in specialized cen e s and signi ican ly imp o ing su i al a es o e ecen decades. Con e sely, in low-
and middle-income coun ies (LMICs), p ena al de ec ion o GIT mal o ma ions is uncommon, pos na al diagnosis is
equen ly delayed, and mo ali y a es emain conside ably highe compa ed o HICs [2,3].
Neona al su ge y has ad anced signi ican ly due o collabo a ion among pedia ic su geons, neona ologis s,
anes he is s, pa hologis s, adiologis s, biochemis s, and nu ses. Ou comes o neona al su gical condi ions ha e
s eadily imp o ed, wi h mo ali y a es o congeni al in es inal obs uc ions a G ea O mond S ee Hospi al d opping
om 50% in he 1950s–60s o unde 5% oday. This p og ess is a ibu ed o a be e unde s anding o neona al
physiology, and ad ances in luid managemen , nu i ion, mechanical en ila ion, and su gical echniques. Howe e ,
challenges emain, pa icula ly in imp o ing su i al a es o se e e condi ions like nec o izing en e ocoli is (NEC)
[4].
Congeni al anomalies o he gas oin es inal ac a e he leading cause o in es inal obs uc ion in newbo ns and
ep esen he mos common su gical eme gency du ing he neona al pe iod. Typical clinical signs include ailu e o pass
meconium, abdominal dis ension, eed egu gi a ion, omi ing, and isible bowel loops. Howe e , hese symp oms can
a y depending on he unde lying cause, he le el o obs uc ion, and i s du a ion. Delayed diagnosis can wo sen
abdominal dis ension, leading o diaph agma ic splin ing and espi a o y dis ess. Complica ions such as aspi a ion
pneumonia, se e e dehyd a ion, pe iphe al ci cula o y ailu e, and me abolic acidosis may a ise. In cases o p olonged
obs uc ion, in es inal gang ene, and pe o a ion can occu , esul ing in pe i oni is and sep icemia [5].
Su gical in e en ions play a i al ole in managing congeni al anomalies, especially in low- and middle-income
coun ies (LMICs), whe e hese condi ions signi ican ly impac child mo bidi y and mo ali y. Howe e , access o quali y
pedia ic su gical ca e in LMICs emains limi ed due o sociocul u al, economic, and s uc u al ba ie s, esul ing in a
conside able unme need. Resea ch indica es ha pedia ic su ge y is a cos -e ec i e solu ion ha can help p e en
p ema u e mo ali y and long- e m disabili ies [6]. This s udy aims o elucida e he spec um o gas oin es inal su gical
condi ions in neona es, highligh ing hei p e alence, associa ed ac o s, su gical in e en ions, and sho - e m
ou comes o in o m clinical p ac ice and enhance neona al ca e.
2. Me hodology
This s udy u ilized a e ospec i e coho design o assess gas oin es inal su gical condi ions in neona es. Medical
eco ds o neona es admi ed wi h hese condi ions om Janua y 2020 o Augus 2022 we e e iewed. A o al o 59
neona es wi h gas oin es inal su gical condi ions we e included in he s udy. All neona es diagnosed wi h
gas oin es inal condi ions equi ing su gical ea men du ing he speci ied pe iod we e included, and hose wi h
incomple e medical eco ds we e excluded.
2.1. Da a Collec ion
Da a we e ex ac ed om medical eco ds and included he ollowing a iables:
• Socio-demog aphic In o ma ion: Age, sex, ges a ional age and ma u i y, bi h weigh , and mode o deli e y.
• Types o gas oin es inal su gical condi ions.
• Su gical In e en ions: Types o su gical p ocedu es pe o med and any associa ed complica ions.
• Sho - e m Ou comes: mo ali y a es, complica ions pos -su ge y, and leng h o hospi al s ay.
2.2. S a is ical Analysis
S a is ical analyses we e conduc ed using app op ia e so wa e, SPSS e sion 24. Desc ip i e s a is ics we e used o
summa ize he da a. Chi-squa e es s we e applied o e alua e co ela ions be ween ca ego ical a iables, while he chi-
squa e es was used o con inuous a iables. A p- alue o <0.05 was conside ed s a is ically signi ican . Mul i a ia e
analyses we e pe o med o iden i y independen p edic o s o su gical ou comes, ocusing on ac o s such as bi h
weigh , an ena al diagnosis, and speci ic gas oin es inal condi ions.
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 27(02), 1458-1464
1460
2.3. E hical Conside a ions
The s udy ecei ed app o al om he e hics commi ees o he Sudan Medical Specializa ion Boa d, he EDC, and he
Minis y o Heal h-Sudan, wi h pe mission om Ib ahim Malik and Kha oum Teaching Hospi als. Pa icipan
con iden iali y was main ained using se ial numbe s.
3. Resul s
The s udy e eals signi ican insigh s in o gas oin es inal su gical condi ions among neona es, highligh ing hei
p e alence, ou comes, and ela ed ac o s. 59 neona es wi h gas oin es inal su gical condi ions we e included wi h a
male- o- emale a io o 1.2:1 and a e m- o-p e e m a io o 7.4:1 [Table 1]. Rega ding bi h weigh , 49 neona es (83%)
had an a e age weigh , while 10 (17%) we e classi ied as low bi h weigh . In e ms o ges a ional age, 52 (88.1%) we e
ull- e m, and 7 (11.9%) we e p e e m. O he neona es, 41 (69.5%) we e deli e ed aginally and 18 (30.5%) by
cesa ean sec ion [Table 2].
Ano ec al mal o ma ions we e he mos common gas oin es inal condi ions, accoun ing o 16 cases (27.1%). This was
ollowed by Hi schsp ung disease in 13 cases (22%), jejunal a esia in 11 cases (18.6%), mal o a ion in 9 cases (15.3%),
esophageal a esia in 5 cases (8.5%), duodenal a esia in 2 cases (3.4%), pylo ic s enosis in 2 cases (3.4%), and
nec o izing en e ocoli is (NEC) in 1 case (1.7%) [Table 3].
The su gical p ocedu es pe o med we e essen ial o he managemen o hese condi ions. The pe o med ope a ions
included: colos omy 19 (32.2%), anoplas y 14 (23.7%), lapa o omy 9 (15.2%), in es inal anas omosis 5 (8.4%),
esophageal anas omosis 5 (8.4%), and Ladd’s ope a ion 5 (8.4%) [Table 4].
The s udy ound a conce ning mo ali y a e o 23.7%, wi h mos dea hs a ibu ed o complica ions such as espi a o y
ailu e and sepsis. Jejunal a esia and ano ec al mal o ma ions we e associa ed wi h he highes mo ali y a es,
highligh ing he se e i y o hese condi ions [Table 5].
S a is ical analysis indica ed signi ican associa ions be ween ce ain ac o s and ou comes. No ably, lowe bi h weigh
and a lack o an ena al diagnosis we e co ela ed wi h poo e ou comes.
Table 1 Demog aphic Cha ac e is ics o Neona es
Cha ac e is ic
Coun
Pe cen age (%)
To al Neona es
59
100
Male
32
54.23
Female
27
45.76
Male- o-Female Ra io
-
1.2:1
Full-Te m
52
88.1
P e e m
7
11.9
Table 2 Bi h Weigh and Deli e y Me hod
Cha ac e is ic
Coun
Pe cen age (%)
A e age Bi h Weigh
49
83.0
Low Bi h Weigh
10
17.0
Vaginal Deli e y
41
69.5
Cesa ean Sec ion
18
30.5
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 27(02), 1458-1464
1461
Table 3 P e alence o Gas oin es inal Su gical Condi ions
Condi ion
Numbe o Cases
Pe cen age (%)
Ano ec al Mal o ma ions
16
27.1
Hi schsp ung Disease
13
22.0
Jejunal A esia
11
18.6
Mal o a ion
9
15.3
Esophageal A esia
5
8.5
Pylo ic S enosis
2
3.4
Duodenal A esia
2
3.4
NEC
1
1.7
To al
59
100%
Table 4 Su gical In e en ions Pe o med
Su gical P ocedu e
Numbe o Cases
Colos omy
19
Anoplas y
14
Rec al Biopsy
11
Lapa o omy
9
In es inal Anas omosis
5
Oesophageal Anas omosis
5
Ladd’s Ope a ion
5
O he s
8
To al
76
Table 5 Associa ion be ween gas oin es inal condi ions and ou come
Diagnosis
To al
Discha ge
No. (%)
Died
No. (%)
Duodenal a esia
2
1 (2.2%)
1 (7.1%)
Jejunal a esia
11
6 (13.3%)
5 (35.7%)
NEC
1
1 (2.2%)
0 (0)
Esophageal a esia
5
3 (6.7%)
2 (14.3%)
Pylo ic s enosis
2
2 (4.4%)
0 (0)
Mal o a ion
9
7 (15.5%)
2 (14.3%)
Hi schsp ung disease
13
13 (28.9%)
0 (0)
Ano ec al mal o ma ion
16
12 (26.7%)
4 (28.6%)
To al
59
45 (100)
14 (100%)
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 27(02), 1458-1464
1462
4. Discussion
The p esen s udy highligh s he epidemiology, su gical managemen , and ou comes o neona al gas oin es inal
su gical condi ions in wo e ia y hospi als in Kha oum, Sudan. The indings emphasize he u gen need o imp o ed
neona al su gical ca e and p ena al diagnos ic p ac ices, pa icula ly in low- esou ce se ings.
In ou s udy, males ep esen ed 54.23% (32) o he cases, yielding a male- o- emale a io o 1.2:1 and a e m- o-p e e m
a io o 7.4:1. This di e s om indings by Asindi e al. in a Saudi A abian s udy, whe e males comp ised 63% o he
cases [7]. In con as , a s udy by Ab ahams e al. in Sou h A ica ound ha males ep esen ed 48% o hei coho , wi h
p e e m cases comp ising 52% [8]. Al hough p e e m neona es a e gene ally a highe isk o gas oin es inal
anomalies due o imma u e o gan de elopmen , he lowe p e alence obse ed in ou coho may sugges
unde diagnosis o educed su i al a es o p e e m in an s in esou ce-limi ed se ings.
In ou s udy, ano ec al mal o ma ions (27.1%) and Hi schsp ung disease (22%) we e he mos common, wi h a no ably
high p e alence o jejunal a esia (18.6%) and mal o a ion (15.3%). Asindi om Saudi A abia iden i ied ano ec al
mal o ma ions, acheoesophageal is ula wi h a esia, in es inal a esia, and Hi schsp ung's disease as he majo
lesions. In con as , Sha ma e al. epo ed a subs an ial inc ease in he incidence o ano ec al mal o ma ions, which
doubled om 2004 o 2014-15. Du ing he same pe iod, admissions o acheoesophageal is ula (TOF) ipled,
ollowed by an inc ease in cases o gas oschisis and omphalocele. Hi schsp ung disease, in es inal obs uc ions, and
a esia we e signi ican con ibu o s [7,9].
Su gical in e en ions we e essen ial in all cases. Colos omy (32.2%) was he mos common p ocedu e, e lec ing i s
pi o al ole in managing ano ec al mal o ma ions and o he obs uc i e condi ions. Anoplas y (23.7%) and lapa o omy
(15.2%) we e also equen ly pe o med. Despi e he su gical successes, he complexi y o neona al su gical ca e
highligh s he need o specialized aining and in as uc u e o imp o e p ocedu al ou comes.
The mo ali y a e o 23.7% is conce ning bu no en i ely unexpec ed in simila con ex s. I unde sco es he complex
in e play o ac o s such as he se e i y o congeni al anomalies, delayed p esen a ion, limi ed an ena al diagnos ic
capabili ies, and challenges in pos ope a i e ca e. Abdul Aziz e al. epo ed ha congeni al gas oin es inal (GIT)
condi ions accoun o up o 40% o eme gency neona al su ge ies, wi h mo ali y a es o en su passing 50% in many
low- and middle-income coun ies (LMICs). The dispa i y in ou comes wo ldwide is s iking; o example, he mo ali y
a e o gas oschisis anges om 75% o 100% in many LMICs, compa ed o less han 4% in high-income coun ies
(HICs). Con ibu ing o hese poo ou comes a e ac o s such as he lack o an ena al diagnosis, delayed p esen a ion,
limi ed neona al anspo and hospi al esou ces, insu icien ained pe sonnel, and inadequa e access o in ensi e
ca e and pa en e al nu i ion o neona es. In Uganda, i is es ima ed ha only 3.5% o he demand o neona al su ge y
is me by he heal hca e sys em [3].
Su gical ou comes o gas oin es inal congeni al anomalies be ween high-income coun ies (HICs) and low- and
middle-income coun ies (LMICs). While HICs achie e a be e esul s, neona al su gical mo ali y a es in LMICs a e
ala mingly high, su passing hose o olde child en and adul s (1%–4%). These inequi ies emphasize neona al su gical
ca e as a global heal h p io i y. The indings also e lec he b oade neglec o pedia ic and neona al su ge y, in global
heal h e o s, wi h minimal ocus on LMICs. Add essing hese gaps equi es u gen in es men and a en ion o imp o e
wo ldwide access and ou comes o neona al su gical ca e [10]. In Sou h A ica, a s udy examining bo h congeni al and
acqui ed abdominal su gical cases ound a 30-day pos ope a i e mo ali y a e o 11% [8].
The s udy ound ha mos dea hs we e a ibu ed o complica ions such as espi a o y ailu e and sepsis. Jejunal a esia
and ano ec al mal o ma ions we e associa ed wi h he highes mo ali y a es, highligh ing he se e i y o hese
condi ions.
S a is ical analysis e ealed c i ical associa ions be ween poo ou comes and ac o s such as low bi h weigh and he
absence o an ena al diagnosis. Low bi h weigh is a well-documen ed isk ac o o neona al mo bidi y and mo ali y,
p ima ily due o educed physiological ese es and inc eased suscep ibili y o in ec ions.
P ena al ul asound is c ucial in de ec ing e al gas oin es inal anomalies, allowing o ea ly diagnosis and op imal
pe ina al ca e. Timely de ec ion acili a es deli e y planning a e ia y cen e s wi h specialized neona al su gical
expe ise, signi ican ly imp o ing ou comes o high- isk neona es. Addi ionally, ou ine ul asound sc eening helps
iden i y associa ed anomalies, which can g ea ly impac p ognosis and managemen s a egies [11].
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 27(02), 1458-1464
1463
Fu he mo e, s eng hening neona al su gical ca e h ough aining p og ams, be e esou ce alloca ion, and pos -
ope a i e suppo sys ems is pa amoun . Emphasis should also be placed on imp o ing neona al in ensi e ca e uni s
(NICUs) o manage complica ions such as sepsis and espi a o y ailu e e ec i ely.
To imp o e ou comes o neona es wi h gas oin es inal anomalies, i is essen ial o s eng hen an ena al sc eening by
s anda dizing ul asound p o ocols o ea ly de ec ion and ensu ing heal hca e p o ide s a e adequa ely ained o
make imely e e als. Pe iope a i e ca e p o ocols should be enhanced o educe mo ali y a es associa ed wi h
espi a o y ailu e and sepsis in he NICU. Addi ionally, conduc ing longi udinal s udies o e alua e he long- e m
ou comes o su gical in e en ions will p o ide aluable insigh s in o su i al a es and quali y o li e. Finally, e o s
mus be made o acili a e equi able access o specialized su gical ca e, pa icula ly in unde se ed egions, o ensu e
imely and e ec i e ea men o all a ec ed in an s.
4.1. S udy Limi a ions and Fu u e Resea ch:
This e ospec i e, wo-hospi al s udy limi s da a comple eness and gene alizabili y, po en ially unde ep esen ing
neona al su gical condi ions egionally. P ospec i e mul icen e s udies a e essen ial o a b oade unde s anding o
hei epidemiology and ou comes.
5. Conclusion
This s udy highligh s he subs an ial challenges posed by gas oin es inal su gical condi ions in neona es, emphasizing
he need o p omp su gical in e en ion and comp ehensi e ca e s a egies. Unde s anding he speci ic condi ions,
associa ed isks, and ou comes is i al o op imizing managemen and imp o ing p ognosis. Fu u e e o s should ocus
on enhancing an ena al sc eening p o ocols and os e ing ea ly diagnosis and ea men , which may imp o e ou comes
o his ulne able popula ion.
Compliance wi h e hical s anda ds
Acknowledgmen s
This s udy was unded solely by he esea che s.
Disclosu e o con lic o in e es
The au ho s decla e ha hey ha e no con lic s o in e es .
S a emen o in o med consen
In o med consen was ob ained om all indi idual pa icipan s included in he s udy.
Re e ences
[1] T öbs R. Re iew. Gas oin es inal su ge y in neona es: p ac ice, ac s, and ends. Open J Pedia . 2019;9(2):154-
182. doi:10.4236/ojped.2019.92017.
[2] Zeng FTA, Mbaye PA, Gueye D, e al. Fac o s associa ed wi h mo ali y in congeni al mal o ma ions o he
gas oin es inal ac in a e ia y cen e in Senegal. Wo ld Jnl Ped Su ge y 2023;6:e000463. doi:10.1136/wjps-
2022-000463
[3] W igh NJ, Global PaedSu g Resea ch Collabo a ion. Managemen and ou comes o gas oin es inal congeni al
anomalies in low, middle and high income coun ies: p o ocol o a mul icen e, in e na ional, p ospec i e coho
s udy. BMJ Open. 2019 Sep 3;9(8):e030452 . doi: 10.1136/bmjopen-2019-030452.
[4] Pie o A, Hall NJ, Chowdhu y MM. Gas oin es inal su ge y in he neona e. Cu Paedia . 2006;16(3):153-164.
doi:10.1016/j.cupe.2006.03.011.
[5] T ipa hy PK, Mohapa a L, Jena PK. A s udy o gas oin es inal ac obs uc ion in neona es and i s managemen . J.
E olu ion Med. Den . Sci. 2020;9(12):943-948, DOI: 10.14260/jemds/2020/203
[6] Si kin NA, Ozgediz D, Donko P, Fa me DL. Congeni al anomalies in low- and middle-income coun ies: he
unbo n child o global su ge y. Wo ld J Su g. 2015;39(1):36-40. doi:10.1007/s00268-014-2714-9
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 27(02), 1458-1464
1464
[7] Asindi AA, Al-Daama SA, Zayed MS, Fa inni YA. Congeni al mal o ma ion o he gas oin es inal ac in Asee
egion, Saudi A abia. Saudi Med J. 2002 Sep;23(9):1078-82. A ailable om:
h p://smj.o g.sa/con en /23/9/1078.
[8] Ab ahams I, Van Wyk L, Vos C. The ou comes o speci ic su gically co ec able congeni al gas oin es inal
mal o ma ions a a e ia y le el neona al in ensi e ca e uni in Sou h A ica. J Neona al Su g. 2023;13(8):8.
doi:10.47338/jns. 13.1250.
[9] Sha ma S, Laddha A, Shukla K. A e ospec i e (2004-2013) and p ospec i e (2014-2015) audi o su gical
diseases o newbo n wi h special e e ence o gas oin es inal diseases and eme gencies o e a pe iod o 10 yea s
a a e ia y ca e cen e. In Su g J. 2016;3(2):718-723. doi:10.18203/2349-2902.isj20160662.
[10] Global PaedSu g Resea ch Collabo a ion. Mo ali y om gas oin es inal congeni al anomalies a 264 hospi als
in 74 low-income, middle-income, and high-income coun ies: a mul icen e, in e na ional, p ospec i e coho
s udy. Lance . 2021 Jul 24;398(10297):325-339. doi: 10.1016/S0140-6736(21)00767-4.
[11] Skupski DW. P ena al diagnosis o gas oin es inal anomalies wi h ul asound. Wha ha e we lea ned?. Ann N Y
Acad Sci. 1998;847:53-58. doi:10.1111/j.1749-6632.1998. b08926.x
