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Epidemiology of adhesions in infants and children following open surgery

Bhanumathi Lakshminarayanan1, Amy O Hughes-Thomas1, Hugh W Grant1

  • 1Department of Pediatric surgery, John Radcliffe Hospital, Headley Way, Headington, Oxford OX3 9DU, UK.

Seminars in Pediatric Surgery
|December 3, 2014
PubMed

Insights

Adhesions after abdominal surgery frequently cause small bowel obstruction in children. Neonates undergoing surgery face higher risks, with specific conditions like malrotation showing higher incidences of adhesive small bowel obstruction (ASBO).

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Surgical Complications

Background:

  • Adhesions are a significant cause of small bowel obstruction after intra-abdominal surgery.
  • Surgical interventions in pediatric patients, particularly neonates, carry an increased risk of adhesion-related complications.

Purpose of the Study:

  • To determine the incidence of adhesive small bowel obstruction (ASBO) in neonates and children following various intra-abdominal surgical procedures.
  • To analyze the prevalence of ASBO across different pediatric surgical conditions.

Main Methods:

  • A comprehensive review of the collective literature was performed.
  • Aggregate mean incidence rates of ASBO were calculated for various neonatal and pediatric surgical interventions.

Main Results:

  • Neonatal laparotomy showed an aggregate mean incidence of ASBO of 6.2%. Higher rates were observed in conditions like malrotation (14.2%) and gastroschisis (12.6%).
  • In children beyond the neonatal period, the aggregate mean incidence of ASBO was 4.7%, with colorectal surgery (14%) and open fundoplication (8.2%) showing higher rates.

Conclusions:

  • Adhesive small bowel obstruction is a notable complication following pediatric intra-abdominal surgery.
  • The incidence of ASBO varies significantly depending on the specific surgical procedure and patient age group, with neonates often at higher risk.

Keywords:
AdhesionsLaparotomyPaediatricsReviewSmall bowel obstruction

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