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Diagnosis and surgical management strategy for pediatric small bowel obstruction: Experience from a single medical

Mingzhu Liu1, Fengchun Cheng1, Xijie Liu1

  • 1Binzhou Medical University Hospital, Binzhou, China.

Frontiers in Surgery
|March 10, 2023
PubMed

Insights

Early surgical intervention for pediatric small bowel obstruction (SBO) is crucial. Immediate surgery is recommended for SBO lasting over 48 hours or with ascites, with laparoscopy as a preferred approach for stable patients.

Area of Science:

  • Pediatric Surgery
  • Gastrointestinal Surgery
  • Surgical Oncology

Background:

  • Pediatric small bowel obstruction (SBO) diagnosis and surgical timing remain challenging.
  • Identifying bowel strangulation and determining optimal surgical intervention are critical for pediatric SBO management.

Purpose of the Study:

  • To analyze factors influencing surgical outcomes in pediatric SBO.
  • To identify predictors of irreversible bowel ischemia and guide surgical approach and timing.

Main Methods:

  • Retrospective review of 75 pediatric patients with surgically confirmed SBO.
  • Classification into groups based on reversible (Group 1) or irreversible (Group 2) bowel ischemia.
  • Analysis of clinical, laboratory, and ultrasonographic findings, including serum albumin and ascites.

Main Results:

  • Group 2 (irreversible ischemia) had higher rates of no prior abdominopelvic surgery, lower serum albumin, and more ascites.
  • Serum albumin correlated negatively with ultrasonographic fluid findings in Group 2.
  • Symptom duration >48 hours increased bowel resection rates; Group 1 had shorter hospital stays.

Conclusions:

  • Immediate surgical intervention for pediatric SBO is advised for symptom duration >48 hours or ultrasonographic evidence of free ascites.
  • Laparoscopic exploration is recommended as the first-line surgical approach for stable pediatric SBO patients.

Keywords:
diagnosisintestinal ischemiamanagementpediatricsmall bowel obstruction

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