Attitudes Affecting Decision-Making for Use of Radiologic Enteral Contrast in the Management of Pediatric Adhesive...

Area of Science:

• Pediatric Surgery
• Gastrointestinal Surgery
• Clinical Decision-Making

Background:

• Limited high-quality data exists for pediatric surgical problems.
• Adult adhesive small bowel obstruction (ASBO) management often uses water-soluble contrast protocols.
• The utility of these adult-based protocols in pediatric ASBO is largely unknown.

Purpose of the Study:

• To investigate pediatric surgeons' decision-making processes for ASBO.
• To understand how adult data is integrated into pediatric ASBO management.
• To identify key factors influencing the use of contrast protocols in children.

Main Methods:

• A web-based survey was distributed to pediatric surgeons within the Western Pediatric Surgery Research Consortium.
• The survey focused on current practices and the incorporation of adult-based evidence for ASBO.

Main Results:

• A 69% response rate was achieved (78/113 surgeons).
• Sixty percent (47/78) of respondents routinely or occasionally use contrast protocols for ASBO management.
• Surgeons noted the need to adapt adult protocols for pediatric patients due to a lack of pediatric-specific data and concerns about adult evidence quality.

Conclusions:

• Pediatric surgeons utilize contrast-based protocols for ASBO management, even with limited pediatric-specific evidence.
• The study provides insight into how pediatric surgeons adapt and integrate adult-derived evidence into their clinical practice for ASBO.