When the Pediatric Gut Stops: The Pattern of Intestinal Obstruction in Children

Background: Intestinal obstruction is a common pediatric surgical emergency and an important cause of morbidity and mortality. This study was conducted to evaluate the current etiological pattern and outcomes of intestinal obstruction in children. Methodology: A retrospective observational study was conducted on 213 children aged 1 month to 15 years presenting with intestinal obstruction at the Department of Pediatric Surgery, Sir Sunderlal Hospital (SSH), Varanasi, India, over 1.5 years (January 2024-June 2025). Clinical, demographic, radiological, operative, and outcome data were reviewed. Statistical analysis was performed using SPSS version 26.0 (IBM Corp., Armonk, NY). Categorical variables were expressed as frequency and percentage, and continuous variables as mean ± standard deviation. Chi-square test was used for categorical comparisons, with p < 0.05 considered statistically significant. Post hoc power analysis was performed to assess sample adequacy. Results: The most common causes of intestinal obstruction were appendicular perforation (37, 17.37%), Meckel’s diverticulum (33, 15.49%), obstructed inguinal hernia (32, 15.02%), and intussusception (30, 14.08%). In infants (n = 44), obstructed inguinal hernia (9, 20.14%), intussusception (8, 18.18%), anorectal malformation (7, 15.91%), and duodenal obstruction (7, 15.91%) were most common. The male-to-female ratio was 139:74. Conservative management was successful in 10 (4.69%) cases, while 203 (95.30%) required surgical intervention. Overall mortality was 2 (0.94%). Conclusion: The etiological pattern of pediatric intestinal obstruction is shifting in developing countries, with appendicular perforation, Meckel’s diverticulum, obstructed hernia, and intussusception emerging as leading causes. Delayed presentation remains the major factor contributing to adverse outcomes.