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Conservative treatment of adhesive small bowel obstruction in children: a systematic review

Lung-Huang Lin1, Chee-Yew Lee2, Min-Hsuan Hung3

  • 1Departments of Pediatrics, Cathay General Hospital, Taipei, Taiwan School of Medicine, FuJen Catholic University, New Taipei City, Taiwan.

BMJ Open
|September 17, 2014
PubMed

Insights

Conservative treatment is effective for pediatric adhesive small bowel obstruction (ASBO). This approach, involving nasogastric decompression and fluid correction, shows success rates from 16% to 75% and reduces hospital stays compared to surgery.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Clinical Effectiveness Research

Background:

  • Adhesive small bowel obstruction (ASBO) is a common surgical complication in children.
  • Conservative management is often the initial approach for pediatric ASBO.

Purpose of the Study:

  • To evaluate the effectiveness of conservative (non-operative) treatment for ASBO in pediatric patients.
  • To compare outcomes of conservative management with surgical intervention.

Main Methods:

  • Systematic review of 7 studies (6 retrospective, 1 prospective) involving children with ASBO.
  • Included patients received conservative treatment: nasogastric decompression, parenteral fluids, and electrolyte correction.
  • Primary outcome was treatment success; secondary outcomes included hospital stay and time to first feeding.

Main Results:

  • Conservative treatment success rates varied from 16% to 75% across studies.
  • Hospital length of stay was significantly shorter with conservative treatment (3-6.5 days) compared to operative treatment (10.2-13 days).
  • Time to first feeding was also reduced with conservative management (31-84 hours).

Conclusions:

  • Conservative treatment is an effective initial management strategy for the majority of pediatric ASBO cases.
  • Non-operative management offers benefits in terms of reduced hospital stay and earlier oral feeding.
  • Further research may refine patient selection for conservative versus operative approaches.
Abstract

Keywords:
QUALITATIVE RESEARCH

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