African Journal of Paediatric Surgery About APSON | PAPSA  
Home About us Editorial Board Current issue Search Archives Ahead Of Print Subscribe Instructions Submission Contact Login 
Users Online: 532Print this page  Email this page Bookmark this page Small font size Default font size Increase font size 
 
ORIGINAL ARTICLE
Year : 2013  |  Volume : 10  |  Issue : 3  |  Page : 259-264

Is non-operative management still justified in the treatment of adhesive small bowel obstruction in children?


Department of Surgery, Division of Paediatric Surgery, University of Ilorin/University of Ilorin Teaching Hospital, Ilorin, Nigeria

Correspondence Address:
Abdulrasheed A Nasir
Division of Paediatric Surgery, Department of Surgery, University of Ilorin Teaching Hospital, PMB 1459, Ilorin
Nigeria
Login to access the Email id

Source of Support: None, Conflict of Interest: None


PMID: 24192472

Rights and PermissionsRights and Permissions

Background: Adhesive small bowel obstruction (ASBO) is a feared complication after abdominal operations in both children and adults. The optimal management of ASBO in the pediatric population is debated. The aim of the present study was to examine the safety and effectiveness of non-operative management in ASBO. Patients and Methods: A retrospective review of 33 patients who were admitted for ASBO over a 5-year period was carried out. Follow-up data were available for 29 patients. Demographic, clinical, and operative details and outcomes were collected for these patients. Data analysis was done with SPSS version 15.0. P ≤ 0.05 was regarded as significant. Results: Out of 618 abdominal surgeries within the 5-year period, 34 admissions were recorded from 29 patients at the follow-up period of 1-28 months. There were 19 boys (65.5%). The median age of patients was 4.5 years. Typhoid intestinal perforation (n = 7), intussusception (n = 6), intestinal malrotation (n = 5), and appendicitis (n = 4) were the major indications for a prior abdominal surgery leading to ASBO. Twenty-five patients (73.5%) developed SBO due to adhesions within the first year of the primary procedure. Of the 34 patients admitted with ASBO, 18 (53%) underwent operative intervention and 16 (47%) were successfully managed non-operatively. There were no differences in sex (P = 0.24), initial procedure (P = 0.12), age, duration of symptoms, and time to re-admission between the patients who responded to non-operative management and those who underwent operative intervention. However, the length of hospital stay was significantly shorter in the non-operative group (P < 0.0001). Five (14.7%) patients had small bowel resection. A 43-day-old child who initially underwent Ladd's procedure died within 15 h of re-admission while being prepared for surgery, accounting for the only mortality (3.4%). Conclusion: Non-operative management is still a safe and preferred approach in selected patients with ASBO. However, 53% eventually required surgery.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed3361    
    Printed111    
    Emailed1    
    PDF Downloaded302    
    Comments [Add]    

Recommend this journal