Background: Pediatric Non-traumatic Surgical Emergencies (PNTSE) are a major part of pediatric surgical emergencies associated with varied spectrum and high morbidity. Aims: The aim of this study is to understand the clinical spectrum and epidemiology of PNTSE. Methods: The children in the age group of 1 month to 14 years admitted in Pediatric Surgery Department in an emergency were studied retrospectively from Jan 2014 to Dec 2018. Children with h/o trauma were excluded. Results: Total of 740 patients with PNTSE was admitted. The males were 65%. The females were 35%. Most of the patients (90%) presented within 48 hours of the appearance of symptoms. The vomiting and pain in the abdomen were the most common symptoms followed by fever, abdominal distension, blood in stools and diarrhea. The ultrasonography was the most common radiological investigation (89.5%) used followed by X-rays (11.4%) and Computed tomography scan (7%). Appendicitis was the most common diagnosis (30.8%) and Intestinal obstruction was the second most common diagnosis (20.3%) followed by abscess/cellulitis (7.8%). The conservative management was done in 24.6% cases. Rest of the cases required surgical intervention. The complications developed in 9.7%. There was a significant difference (p ≤ 0.0001) in the occurrence of complications between patients getting admitted within 48 hours and after 48 hours of onset of symptoms as well as between the conservatively managed patients and the surgically managed cases. There were four mortalities. Average hospital stay was 5.19 days. Conclusions: The PNTSE have a varied spectrum of presentation. The early diagnosis and appropriate intervention within 48 hours can decrease the complications. The patients undergoing surgical management have higher complications compared to those with conservative management. The PNTSE have a better outcome with the team approach involving Pediatric surgeon, Pediatric Anesthetist, Pediatric Intensivist and Radiologist.

Keywords: Pediatric non-traumatic surgical emergencies; Pediatric surgical emergency management.