Clinical data on nineteen patients with small bowel obstruction due to congenital anomalies coveting 8 year period from January, 1969 to August, 1976 at the Department of Surgery of Seoul National University Hospital are presented and the literature is reviewed.
The nineteen cases of congenital small bowel, obstruction included 9 male and 10 female patients and two of the patients were premature by having a birth weight under 2,500 gm. Duodenal obstruction was present in 10 of the patients reviewed and jejuno ileac obstruction in 9 Bilious vomiting was recorded in 100 percent abdominal distension developed in 70 percent and 58 percent of these patients did not pass meconium. Jaundice occurred in 4 patients, who have normal birth weight. First bilious vomiting were noted within the third day in 17 patients (89%) and 8 patients of them on the first day. Polyhydramnios was present in one case with annular pancreas and premature rupture of membrane was present in the patient with preduo-denal portal vein and hepatic artery. Associated malformations were present in 5(26%) l of the total.
10 cases (53%o) were admitted within four days after birth in spite of 89 percent of the total cases showed first bile-stained vomiting in 3-days after-birth. Once the patients were hospit-alized, early diagnosis as congenital small bowel obstruction needing, surgical intervention was obtained easily in neally all (95%) of them after history taking, physical examination, simple abdominal roentgenogram and gastro-intestinal contrast study. The cause of death was respiratory distress in two patients and one of them the body weight was 1, 000 GM. The overall survival rate for the patient was 84 percent and the mean days of hospitalization was 12.
In Korea, 95 cases of congenital small bowel obstruction including these 19 cases are repor-ted on the literatures. Early detection of this anomalies will be more easily obtained if we always keep in mind´ the congenital small bowel obstruction when the cardinal signs of.obstru ctiom suchr:as maternal polyhydramnios, bilious vomiting, abdominal, distension and failure to pass meconium were obtained an the neonate.
Many of congenital small bowel, obstructions are potentially easily, correctable if they had no, associated severe prematurely and major congenital malformations and later prognosis of the survivors is optimistic if the initial postoperative course is well tolerated.
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