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Chronic bilious vomiting in children in developing countries due to high bowel obstruction: not always malrotation

Anand Pandey1, V Kumar, A N Gangopadhyay

  • 1Department of Pediatric Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India. dranand27@rediffmail.com

Pediatric Surgery International
|November 14, 2009
PubMed

Insights

Jejunal stricture (JS) caused by non-specific jejunoileitis (NSJI) is a frequent cause of bilious vomiting in children. Surgical intervention yields excellent outcomes for this condition.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Pathology

Background:

  • Bilious vomiting with abdominal pain often indicates a surgical issue.
  • Jejunal stricture (JS) from non-specific jejunoileitis (NSJI) is a significant cause of high small bowel obstruction and vomiting in children.

Purpose of the Study:

  • To evaluate jejunal stricture (JS) as a cause of chronic high small bowel obstruction and bilious vomiting in children.
  • To assess diagnostic methods and treatment outcomes for JS in pediatric patients.

Main Methods:

  • Retrospective analysis of 100 children with bilious vomiting and failure to thrive.
  • Investigations included oral contrast studies, ultrasound, chest X-ray, and Mantoux test.
  • Diagnosis confirmed by laparotomy and histopathology; treatment involved jejunal resection and anastomosis.

Main Results:

  • 25 out of 100 patients had JS; radiologic confirmation in 19 (76%).
  • No tuberculosis (TB) was diagnosed.
  • Histopathology showed non-specific ischemic changes in all JS specimens.

Conclusions:

  • Jejunal stricture (JS) due to NSJI is a common cause of bilious vomiting in this pediatric population.
  • Contrast studies aid in suspicion, but histopathology is crucial for diagnosis.
  • Surgical treatment for JS provides excellent results.
Abstract

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