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[Intestinal obstruction after child abdominal surgery (author's transl)]
Insights
Intestinal obstructions frequently occur after appendectomies, particularly in the first year post-surgery. This study analyzes 211 cases, highlighting timing and risk factors for these serious surgical complications.
Area of Science:
- Gastroenterology
- Pediatric Surgery
- Surgical Complications
Context:
- This retrospective study analyzes 211 cases of intestinal obstruction treated between 1957 and 1978 at Hôpital des Enfants malades, Paris.
- Data includes obstructions from both internal and external surgical centers, providing a broad overview of the condition.
- The study focuses on obstructions occurring after previous surgeries, particularly appendectomies.
Purpose:
- To investigate the incidence, timing, and characteristics of intestinal obstructions following surgery in children.
- To identify key risk factors and patterns associated with post-operative intestinal obstructions.
- To provide insights into the clinical presentation and anatomical locations of these obstructions.
Summary:
- A significant proportion of intestinal obstructions (61%) occurred after appendectomy, with 74% of these happening within the first year post-operation.
- Early mechanical intestinal obstruction, occurring between 8 days and 7 years after the initial surgery, showed a high incidence within the first year (72%).
- The study observed obstructions in various pediatric age groups, with notable peaks in neonates after surgery and children aged 5-9 years during the 'appendicitis period'.
Impact:
- Highlights the significant risk of intestinal obstruction as a complication following appendectomy in pediatric patients.
- Informs surgical practices by detailing the critical timeframes for obstruction development post-surgery.
- Provides valuable data for understanding the long-term sequelae of abdominal surgery in children, aiding in preventative strategies and patient monitoring.
Abstract:
From 1957 to 1978, 211 intestinal obstructions were treated at Hôpital des Enfants malades, Paris: 103 coming from our own surgery, 108 from other surgical centers. 24,6% cases are observed in children less than one year old, after neo-natal surgery. 41% are observed between 5 and 9 years of age, at the "appendicitis period". 61% obstructions follow an appendicectomy. 74% of obstructions happen in the first year after surgery, of which 32% in the first month (the early mechanical intestinal obstruction between 8 days and 7 years after the first obstruction: 72% in the first year, of which 30,5% within the first month. Some precisions are given about clinical symptoms, site and intestinal lesions. The study of the preventive surgical procedures (Noble's, or Child-Philip's technics) are not included in this paper.