[Contamination of the small intestine as a cause for ileus attacks in children after intestinal surgery]
Related Experiment Videos
Insights
Contaminated small bowel syndrome (CSBS) in children, often following neonatal surgery, presents as abdominal emergencies. Prompt antibiotic treatment effectively resolves CSBS symptoms, potentially avoiding surgical intervention.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Infectious Diseases
Background:
- Contaminated small bowel syndrome (CSBS) is a rare condition affecting children, particularly those with a history of neonatal laparotomy.
- Patients typically present with severe gastrointestinal symptoms mimicking intestinal obstruction.
Purpose of the Study:
- To report the successful management of eight pediatric cases of CSBS.
- To highlight the diagnostic criteria and effective treatment for CSBS.
- To emphasize the importance of considering CSBS in the differential diagnosis of pediatric abdominal emergencies.
Main Methods:
- Diagnosis involved clinical examination, plain abdominal X-rays, and microbiological analysis (Gram stain and cultures) of nasogastric aspirates.
- Treatment consisted of targeted antibiotic therapy.
Main Results:
- Eight children aged 3 months to 7 years with CSBS were successfully treated.
- All patients experienced rapid symptom resolution within days of commencing antibiotic therapy.
- Diagnostic findings included bile-stained vomiting, diarrhea, abdominal distension, and signs of mechanical obstruction on X-ray.
Conclusions:
- CSBS is a treatable cause of pediatric abdominal emergencies.
- Antibiotic therapy is effective in managing CSBS and may prevent the need for exploratory laparotomy.
- Early consideration of CSBS in the differential diagnosis is crucial for appropriate management.
Abstract:
During the last two years eight children aged 3 months to 7 years were treated successfully for contaminated small bowel syndrome (CSBS). All patients had a history of a laparotomy in the neonatal period and showed bile stained vomiting and diarrhoea. On examination, a painful distended abdomen with hyperactive bowel sounds was found. Plain abdominal x-rays showed signs of mechanical intestinal obstruction. The diagnosis of CSBS was made by positive gram stain and cultures of samples taken via a nasogastric tube. After antibiotic treatment the symptoms disappeared within a few days. We therefore believe that CSBS should always be considered in the differential diagnosis of abdominal emergencies. Our views agree with those of other authors in so far as we feel that antibiotic therapy may help to avoid unnecessary laparotomies in such cases.